| NPI | 1972257095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN KONOMI WOLF Pediatric Dentist 843-321-9944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2023-02-17 |