| NPI | 1508004268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHALL VERNON MILLER Partner 843-764-3081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 1560) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 4369) |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2009-02-03 |