| NPI | 1790827160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA GRANT GUESS Owner 843-208-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4081) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2015-07-01 |