| NPI | 1396829693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | A G BURRIS Managing Member 843-986-9339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 3628) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |