| NPI | 1902094402 |
|---|---|
| Doing Business As | DENTAL OFFICE |
| Entity Type | Organization |
| Authorized Contact | CORNELIUS JOHNATHAN BECK Owner 843-215-0579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 2222) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-09 |