| NPI | 1669537833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS A. HASSELL Owner 843-767-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223G0001X Dentist General Practice | |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223P0300X Dentist Periodontics | |
| 1223P0700X Dentist Prosthodontics | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| 126900000X Dental Laboratory Technician | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |