| NPI | 1548228521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES PARK Office Manager/Corporate Secretary 803-796-2637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 3398) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2014-04-09 |