| NPI | 1336556869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CHAD COLSON Owner/Dentist 864-271-6705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 3702) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: SC 4009) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2014-07-16 |