| NPI | 1740478668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD VANDIVER HORTON Partner 843-449-7114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 1537 AND 4131) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2007-10-04 |