| NPI | 1902221757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WILLIAM DICKERT Dentist 843-571-7951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4458) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2014-03-03 |