Organization
THE BRACES PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT F. GARRISON (OWNER)
(803) 661-8468
Entity
Organization
Contact information
Practice address
921 LONGTOWN RD, SUITE B, COLUMBIA, SC 29229-9498
(803) 661-8468
Mailing address
921 LONGTOWN RD, SUITE B, COLUMBIA, SC 29229-9498
(803) 661-8468
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30-2494
SC
302F00000X
Exclusive Provider Organization
4641765
SC
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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