| NPI | 1396445508 |
|---|---|
| Doing Business As | UNIVERSITY DENTAL PA |
| Entity Type | Organization |
| Authorized Contact | MAKEEBA BOOKHART POUGH Owner/Member 803-260-0807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-09-21 |