| 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 |