| NPI | 1952517161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MARK BARRY Associate Dean For Clinical Affairs 843-792-2142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SC SC-3198) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |