| NPI | 1689184129 |
|---|---|
| Doing Business As | DENTALHOME OF COVINGTON |
| Entity Type | Organization |
| Authorized Contact | MONIQUE TUCKER Director Of Insurance 843-990-9998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2017-12-08 |