| NPI | 1578009056 |
|---|---|
| Former Legal Business Name | SOUTH CAROLINA PERIODONTOLOGY |
| Entity Type | Organization |
| Authorized Contact | MATTHEW JOSEPH ROWE Owner/Manager 803-782-0528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC 8489) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |