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NPI Code Detail

MEDICARE: RESTORATIVE ARTS DENTAL PA

MEDICARE: RESTORATIVE ARTS DENTAL PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223D0001XPublic Health Dentistry

General Provider Information

NPI Number : 1043962186
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESTORATIVE ARTS DENTAL PA
Provider Business Mailing Address
First Line : 669B W WESMARK BLVD
Second Line :
City : SUMTER
State : SC
Zip : 29150-1900
Country : US
Telephone Number : 803-905-3567
Fax Number : 803-905-3507
Provider Business Practice Location Address
First Line : 669B W WESMARK BLVD
Second Line :
City : SUMTER
State : SC
Zip : 29150-1900
Country : US
Telephone Number : 803-905-3567
Fax Number : 803-905-3507
Authorized Official
Title or Position : OFFICE MANAGER
Name : GLORIA ANGELA STOKES PAULY
Credential :
Telephone Number : 803-905-3567
Provider Enumeration Date : 01/20/2022
Last Update Date : 03/09/2026

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Directions to “RESTORATIVE ARTS DENTAL PA ” Practice Location

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