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General NPI Number Information
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NPI Number | 1821201708
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Entity Type | Organization
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Legal Business Name | SUMMERS ORTHODONTICS, PA
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4501 OLD SPARTANBURG RD STE 2
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City | TAYLORS
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State | SC
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Zip | 29687-4105
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Country | US
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Telephone | 864-244-7545
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Fax | 864-244-7767
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Provider Business Mailing Address
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Address Line | 4501 OLD SPARTANBURG RD STE 2
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City | TAYLORS
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State | SC
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Zip | 29687-4105
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Country | US
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Telephone | 864-244-7545
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Fax | 864-244-7767
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFERY CRAIG SUMMERS
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Credential | D.M.D.
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Telephone | 864-244-7545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0573
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License Number State | SC
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