| NPI | 1871779413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFTON JORDAN Owner/Dentist 803-531-1601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4010) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-01-14 |