| NPI | 1518191105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY JOSEPH WYCH Owner 803-779-9666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 2905) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2009-05-11 |