| NPI | 1700494309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN C. AVEY President 803-650-3068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2023-09-26 |