| NPI | 1487712535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN LEWIS NICHOLS President 843-795-8787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 3467) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-08-22 |