# SUMTER ORAL & MAXILLOFACIAL SURGERY PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dental Implant Center of Sumter
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083677884
- **Authorized official:** DR. MICHAEL A MCGINNIS DDS (OWNER)
- **Authorized official phone:** (803) 905-4404

## Contact information

- **Practice address:** 1210 WILSON HALL RD, SUMTER, SC 29150-1889
- **Practice address phone:** (803) 905-4404
- **Practice address fax:** (803) 905-4406
- **Mailing address:** 1210 WILSON HALL RD, SUMTER, SC 29150-1889
- **Mailing address phone:** (803) 905-4404
- **Mailing address fax:** (803) 905-4406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3273 | SC | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 474 | SC | Yes |

## Other

- **Enumeration date:** 04/11/2006
- **Last updated:** 01/14/2011