| NPI | 1952865289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY WHITE BROWN Orthodontist 803-699-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2022-08-18 |