Individual
JOHN SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4444 BROAD RIVER RD, COLUMBIA, SC 29210-4012
(803) 896-2135
Mailing address
1944 PRICEVILLE RD, GILBERT, SC 29054-9782
(803) 892-3155
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2550
SC
Other
Enumeration date
04/04/2006
Last updated
07/08/2007
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