| NPI | 1487670667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY C KIMSEY President 803-548-3342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 2588) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 3549) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-07-16 |