| NPI | 1902013162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD C. MATHIS Owner 864-574-0762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 1992) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |