NPI | 1326332628 |
---|---|
Entity Type | Organization |
Authorized Contact | AMANDA SPIVEY GREEN Dentist 864-585-8558 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC 3703) |
Enumeration Date | 2011-06-03 |
Last Update Date | 2024-01-31 |