# ANDERSON ORAL AND MAXILLOFACIAL SURGERY, PA

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

## Provider details

- **NPI number:** 1326173428
- **Authorized official:** MR. LEWIS TYLER SUMNER D.M.D. (PHYSICIAN/ OWNER)
- **Authorized official phone:** (864) 226-7503

## Contact information

- **Practice address:** 1209 ELLA STREET, ANDERSON, SC 29621
- **Practice address phone:** (864) 226-7503
- **Practice address fax:** (864) 225-4937
- **Mailing address:** 1209 ELLA STREET, ANDERSON, SC 29621
- **Mailing address phone:** (864) 226-7503
- **Mailing address fax:** (864) 225-4937

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 3483 | SC | Yes |

## Other

- **Enumeration date:** 02/22/2007
- **Last updated:** 12/06/2013