| NPI | 1609207554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK F YAMPOLSKY Owner 843-556-8778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: SC 2962) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: SC 6934) |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2013-12-03 |