NPI | 1558388413 |
---|---|
Entity Type | Organization |
Authorized Contact | DANA LYNN BLALOCK Dentist Partner 843-559-3530 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3158) |
Enumeration Date | 2006-07-16 |
Last Update Date | 2020-08-22 |