| NPI | 1467587477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER EDWARDS BUTLER President 843-488-2526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 3767) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-08-21 |