| NPI | 1891710372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL P JOHNSTON President 803-377-4113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 2276) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 2365) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-08-22 |