| NPI | 1689764599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUGES F STOCKTON Vice President 803-735-5446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 3901) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2008-05-13 |