NPI | 1972725299 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES J NYLAND Owner President 803-772-7302 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 1707) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC Specialty 0160) |
Enumeration Date | 2007-05-03 |
Last Update Date | 2023-03-07 |