| NPI | 1861594640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY NIRENBLATT President 843-572-1060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 0400) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2007-10-18 |