| NPI | 1669518809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDELL S JOHNSON Pres 843-766-7880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 1022SC) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |