| NPI | 1386805588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE CARROLL SWASTY Orthodontist 843-871-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC 4439) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2008-06-19 |