| NPI | 1902884984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MARTINEZ Office Assitant 864-232-1574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC za9916) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2020-08-22 |