| NPI | 1497397574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC DAVID WORKMAN Owner 864-235-3949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-10 |