| NPI | 1669039483 |
|---|---|
| Doing Business As | SOUTH CAROLINA DENTAL SLEEP, FIVE FORKS |
| Entity Type | Organization |
| Authorized Contact | BETH LOUISE ILLSLEY Director Of Insurance 864-282-1935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-05-28 |