| NPI | 1629893805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRISON EUGENE COPELAND Orthodontist 862-451-8117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-11-21 |
| Last Update Date | 2024-11-21 |