| NPI | 1568654275 |
|---|---|
| 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 |