NPI | 1396963443 |
---|---|
Entity Type | Organization |
Authorized Contact | SUZANNE SPROUSE POWELL Co Owner/General Dentist 843-761-8065 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3119 SC) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 1641 SC) |
Enumeration Date | 2007-04-23 |
Last Update Date | 2023-09-19 |