| NPI | 1700011467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA LOCKE Office Manager 843-225-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 2008) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2009-05-26 |