| NPI | 1518070846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHEA WALTERS RICHARDSON Partner 803-776-4234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 1825) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |