| NPI | 1841638376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD F PORCELLI Owner/Dentist 843-441-8852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC 4530) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: SC 8083) |
| 261QD0000X Clinic/Center, Dental (Licence: SC 4659) | |
| 261QD0000X Clinic/Center, Dental (Licence: SC 1985) | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2013-06-06 |