| NPI | 1447685763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE A BENTON Office Manager 843-545-1295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 6915) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |