| 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 |