| NPI | 1710106919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY BARTLETT Office Manager 803-736-1330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 1315) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |