| NPI | 1548660053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC BRANDON ROBERTS Lab Manager 843-761-6411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 292200000X Dental Laboratory (Licence: SC 555) |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2014-09-03 |