| 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 |