| NPI | 1952086027 |
|---|---|
| Doing Business As | SOUTHERN MAGNOLIA DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | DAVID EDWARD URBANAWIZ Owner 803-648-9511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-06-16 |
| Last Update Date | 2023-06-16 |