| NPI | 1437280013 |
|---|---|
| Doing Business As | SOUTH PARK |
| Entity Type | Organization |
| Authorized Contact | RAYMOND GARRISON President 704-549-1509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 3549) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |