| NPI | 1407813983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY N PATTERSON Business Assistant 803-254-7791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 0874) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 3038) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2020-08-22 |