| NPI | 1760664304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT RAY CUNNINGHAM Owner 803-917-6962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4114) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2007-12-05 |