| NPI | 1780736546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY L RANEY Office Manager 843-671-7336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 4076) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |