| NPI | 1831250273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE D. HARTZOG Office Manager 803-536-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 1836) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2007-12-26 |