| NPI | 1568591469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENLEY JACKSON LOFTIS Owner 803-794-8741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3331) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2010-09-23 |