| NPI | 1457337495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE M LOWRY Office Manager 864-984-6888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3380) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 4036) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2020-08-22 |