| NPI | 1679779888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON FITTS JOHNSON Co President 803-788-2560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC SC4008) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-08-22 |