| NPI | 1790090769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICLE L DAHLKEMPER Owner 843-884-6166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2010-08-13 |