| NPI | 1902038052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON SCOTT ROGERS Owner/Dentist 864-715-0688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC 4024) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2009-08-21 |