| NPI | 1881800480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINONA M NEWMAN Owner 843-294-5437 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 3125SC) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 3125) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2010-03-03 |