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Organization
ANDERSON ORAL AND MAXILLOFACIAL SURGERY, PA
Active
Organization
ANDERSON ORAL AND MAXILLOFACIAL SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEWIS TYLER SUMNER D.M.D. (PHYSICIAN/ OWNER)
(864) 226-7503
Entity
Organization
Contact information
Practice address
1209 ELLA STREET, ANDERSON, SC 29621
(864) 226-7503
(864) 225-4937
Mailing address
1209 ELLA STREET, ANDERSON, SC 29621
(864) 226-7503
(864) 225-4937
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3483
SC
Other
Enumeration date
02/22/2007
Last updated
12/06/2013
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