NPI | 1508069006 |
---|---|
Former Legal Business Name | AMANDA GREGORY FAMILY COSMETIC DENTISTRY |
Entity Type | Organization |
Authorized Contact | MELISSA A WEBSTER Office Manager 843-871-9924 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2007-06-11 |
Last Update Date | 2020-06-17 |