| NPI | 1720711641 |
|---|---|
| Doing Business As | MOD AESTHETICS |
| Entity Type | Organization |
| Authorized Contact | MICHAEL R DEFEE Dentist 843-216-3484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2022-07-07 |