| NPI | 1972877710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BURRIS KENNA Manager 864-438-2646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 4272) |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2012-02-24 |