| NPI | 1669838991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN DERRICK Owner/Dentist 864-243-8371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3949) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2015-12-31 |