| NPI | 1992924534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL A. MCGLAME Insurance Coordinator 843-849-5188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC 3426) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2008-06-30 |