NPI | 1639406390 |
---|---|
Entity Type | Organization |
Authorized Contact | CALVIN VICTOR BOYKIN Owner 864-306-8350 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4113) |
Enumeration Date | 2009-11-17 |
Last Update Date | 2009-12-08 |