NPI | 1558543249 |
---|---|
Doing Business As | SMILE CENTER OF KNIGHTSVILLE |
Entity Type | Organization |
Authorized Contact | JEANINE ALICIA GOURDINE Owner/Dentist 843-261-0123 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4061) |
Enumeration Date | 2007-12-04 |
Last Update Date | 2007-12-04 |