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 |