| NPI | 1700916822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN NITKA Office Manager 803-699-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: SC 3160) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |