| NPI | 1982141750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEBEDIAH S CHRISTY Owner/Dds 843-592-3909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SC 8613) |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2017-01-31 |