| NPI | 1700931987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY E BARNES Office Manager 843-527-2081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC 2206) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |