Organization
SIGNATURE SMILES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAKE MICHAEL JULIAN MD (PRACTICE OWNER)
(864) 271-6213
Entity
Organization
Contact information
Practice address
1730 HENDERSON ST STE A, COLUMBIA, SC 29201-2648
(803) 252-5068
Mailing address
1730 HENDERSON ST STE A, COLUMBIA, SC 29201-2648
(803) 252-5068
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6903
SC
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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