Provider Demographics
NPI:1831634492
Name:SUMMERS, MARGARET LAUREN (DENTAL HYGIENIST)
Entity type:Individual
Prefix:MISS
First Name:MARGARET
Middle Name:LAUREN
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 CAMP RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-8530
Mailing Address - Country:US
Mailing Address - Phone:803-707-7134
Mailing Address - Fax:
Practice Address - Street 1:100 OLD CHEROKEE RD
Practice Address - Street 2:SUITE F PMB 14
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-9316
Practice Address - Country:US
Practice Address - Phone:803-808-2304
Practice Address - Fax:803-808-5642
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10323124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist