| NPI | 1699073841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ANTONIO GILLIARD Owner/Dentist 843-761-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC 3735) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2011-03-10 |