| NPI | 1932457751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA DAVIS CEO 843-663-8000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-08-28 |