| NPI | 1386734804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH LLOYD GUDZ President 843-785-4801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC SC3319) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |