| NPI | 1477065787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULETTE WRIGHT Manager 843-525-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 5831-15) |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2017-10-26 |