| NPI | 1427268648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M FARIS Owner 864-282-8555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 3683) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-05-20 |