| NPI | 1790953602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM SCOTT GARRIS Owner 843-563-3208 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3524) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2008-02-13 |