| Dental Implant Center Of Sumter | |
|
1210 Wilson Hall Rd Sumter SC 29150-1889 | |
| (803) 905-4404 | |
| (803) 905-4406 |
| Full Name | Dental Implant Center Of Sumter |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1210 Wilson Hall Rd, Sumter, South Carolina |
| Authorized Official Name and Position | Michael A Mcginnis (OWNER) |
| Authorized Official Contact | 8039054404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Implant Center Of Sumter 1210 Wilson Hall Rd Sumter SC 29150-1889 Ph: (803) 905-4404 | Dental Implant Center Of Sumter 1210 Wilson Hall Rd Sumter SC 29150-1889 Ph: (803) 905-4404 |
| NPI Number | 1083677884 |
|---|---|
| Provider Enumeration Date | 04/11/2006 |
| Last Update Date | 01/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083677884 | NPI | - | NPPES |
| ZA9858 | Medicaid | SC | |
| 872701 | Other | UNITED CONCORDIA | |
| 88003121 | Other | AL | BLUE CROSS BLUE SHIELD |
| ZDK433 | Other | MA | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3273 (South Carolina) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 474 (South Carolina) | Primary |
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