Organization
DENTAL ASSOCIATES OF SUMMERVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA GROOMS (ADMINISTRATIVE ASSISTANT)
(843) 873-3706
Entity
Organization
Contact information
Practice address
209 W 5TH NORTH ST, SUMMERVILLE, SC 29483-6511
(843) 873-3706
Mailing address
209 W 5TH NORTH ST, SUMMERVILLE, SC 29483-6511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
SC
Other
Enumeration date
04/11/2007
Last updated
08/22/2020
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