| NPI | 1477781862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JEREMY WORD Owner 864-423-9190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4360) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2009-06-24 |