| NPI | 1740828904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP BONDS President Of Member Entity 843-665-8176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2019-12-18 |