| NPI | 1750783338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK CHARLES SPARACINO Owner 843-553-5355 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: SC 1633623) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |