NPI | 1619337722 |
---|---|
Entity Type | Organization |
Authorized Contact | CRYSTAL VANDERLIND Office Staff 864-437-8606 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 3638) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
Enumeration Date | 2016-03-02 |
Last Update Date | 2016-03-02 |