Organization
OMNI DENTAL OF SUMTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ELLIS DMD (OWNER)
(803) 413-5100
Entity
Organization
Contact information
Practice address
625 CONSTITUTION DR, SUMTER, SC 29154-8190
(803) 773-5413
Mailing address
212 OUTLET POINTE BLVD, COLUMBIA, SC 29210-5667
(803) 830-3008
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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