| NPI | 1821274598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LEA BAILEY Dentist 843-524-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 4161) |
| Enumeration Date | 2008-01-12 |
| Last Update Date | 2008-01-12 |