| NPI | 1619926128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JANE WALDROP Insurance Specialist 864-297-6365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 2558) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-08-22 |