| NPI | 1598932881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE STONE Doctor 843-556-6566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 3138) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 3189) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |