| NPI | 1992955249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH WILLIAM STREET Orthodontist 864-224-2526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SC 2894 SPEC 0391) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2008-09-23 |