| NPI | 1891069944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN MANN BAUER CFO 843-757-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC dgd4574gd) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |