| Summerton Smiles For A Lifetime | |
|
9077 Alex Harvin Hwy Summerton SC 29148-9803 | |
| (803) 478-6277 | |
| (803) 478-6284 |
| Full Name | Summerton Smiles For A Lifetime |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9077 Alex Harvin Hwy, Summerton, South Carolina |
| Authorized Official Name and Position | Georgia Bennett Famuliner (OPERATIONS DIRECTOR) |
| Authorized Official Contact | 8035844803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summerton Smiles For A Lifetime Po Box 767 Summerton SC 29148-0767 Ph: (803) 478-6277 | Summerton Smiles For A Lifetime 9077 Alex Harvin Hwy Summerton SC 29148-9803 Ph: (803) 478-6277 |
| NPI Number | 1386727188 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 09/20/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386727188 | NPI | - | NPPES |
| ZA9502 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |