# SUMMERVILLE PEDIATRIC DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275764672
- **Authorized official:** DOROTHY M BAKER DMD PC (OWNER)
- **Authorized official phone:** (873) 871-6433

## Contact information

- **Practice address:** 405 W 5TH NORTH ST STE A, SUMMERVILLE, SC 29483-6515
- **Practice address phone:** (843) 871-6433
- **Mailing address:** 405 W 5TH NORTH ST STE A, SUMMERVILLE, SC 29483-6515
- **Mailing address phone:** (843) 871-6433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 3903 | SC | Yes |

## Other

- **Enumeration date:** 08/03/2009
- **Last updated:** 08/03/2009