| NPI | 1952684300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA CAROL BAKER Office Manager 864-295-0441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 3174) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-09-22 |