| NPI | 1366805152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL F GROSSO Owner/Orthodontist 843-899-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 2722) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |