| NPI | 1932121837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY SCOTT WOOSTER President 843-815-7844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3360) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-08-22 |