NPI | 1558432146 |
---|---|
Entity Type | Organization |
Authorized Contact | KENDON A ROSS Officer 864-882-0620 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3260) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 3286) |
Enumeration Date | 2006-11-13 |
Last Update Date | 2020-08-22 |