| NPI | 1710008099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY LYNN PAGE Office Manager 864-246-2181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 4271) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |