| NPI | 1841308871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R. JASON MEARES President 843-357-2122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3389) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: SC 479-PROS) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-22 |