NPI | 1760633259 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHEN SEAN VALIS Owner 803-328-3886 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3308) |
Enumeration Date | 2008-10-02 |
Last Update Date | 2008-10-02 |