| NPI | 1457666471 |
|---|---|
| Former Legal Business Name | PALMETTO DENTAL SPECIALISTS LLC |
| Entity Type | Organization |
| Authorized Contact | CHAD ROBERT MATTHEWS Periodontist/Owner 803-579-0026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: SC Dental: 4658) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: SC Dental: 4667) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2010-08-13 |