| NPI | 1386891463 |
|---|---|
| Former Legal Business Name | J. MICHAEL HAVIRD, DMD, PC |
| Entity Type | Organization |
| Authorized Contact | JULIE CORLEY Office Manager 803-279-0015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: SC 2109) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2008-08-20 |