Organization
DENTAL WELLNESS CENTER OF SUMTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTIE LAWRENCE (FINANCIAL COORDINATOR)
(912) 920-5577
Entity
Organization
Contact information
Practice address
1322 BROAD ST STE 90, SUMTER, SC 29150-1984
(803) 883-0857
(912) 226-3489
Mailing address
PO BOX 60339, SAVANNAH, GA 31420-0339
(912) 920-5577
(912) 226-3489
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497918759
NPI
GA
01
—
DN010747
STATE LICENSE
GA
Enumeration date
03/05/2019
Last updated
06/11/2019
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