| NPI | 1952570103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN J STOLLER President/Owner 864-288-6404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3444) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2008-02-21 |