| NPI | 1891938973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN MICHAEL BOZARD President 864-699-6382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 4566) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2019-11-15 |