| NPI | 1851559629 |
|---|---|
| Doing Business As | BLYTHWOOD VILLAGE DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | JOHN C COSBY Owner President 803-754-9160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC SC1677) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |