| NPI | 1437365996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMONS HANE Chairman 843-729-5409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: SC 03964) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |