| NPI | 1689883662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL MICHAEL HAZEL Owner 843-549-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 2032) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |