| NPI | 1376809772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL R MUNN Orthodontist 843-293-3522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 4318) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-10 |