| NPI | 1609361351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE DAHLKEMPER Owner 843-884-6166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2019-06-28 |