NPI | 1437748647 |
---|---|
Doing Business As | OLDE TOWN DENTISTRY |
Entity Type | Organization |
Authorized Contact | SHAWN C EDWARDS Owner 864-859-0111 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2021-01-12 |
Last Update Date | 2025-03-18 |