| NPI | 1851662274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS COLLINS Owner 803-772-7302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 4507) |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2022-12-30 |