NPI | 1417053406 |
---|---|
Entity Type | Organization |
Authorized Contact | ASA DUNCAN SHIRLEY Dentist/Owner 864-592-1647 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: SC SC1863) |
Additional Taxonomies | 122300000X Dentist (Licence: SC SC1228) |
122300000X Dentist (Licence: SC SC3766) | |
Enumeration Date | 2006-09-16 |
Last Update Date | 2020-08-22 |