| NPI | 1538603303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC E RADABAUGH Director 843-364-6695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 8533) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2016-12-13 |