| NPI | 1821255191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID RIORDAN President 803-802-2580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC 25540552) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2008-05-22 |