| NPI | 1568654275 |
|---|---|
| Former Legal Business Name | EDWARD M WISE DMD |
| Entity Type | Organization |
| Authorized Contact | VIRGIE D GURGANIOUS Office Mgr 843-521-4344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC z1777) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2010-10-27 |