| NPI | 1841698149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY CHARLES MARTIN President 803-749-6072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC 2590) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |