OrganizationActive
1724 State Summerville Professional, LLC
NPI 1730847724 · General Practice Dentistry · Summerville, SC
Provider details
- NPI number
- 1730847724
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Authorized official
- Peter Grumbos, Owner
Practice location
1724 State Rd Unit 4d
Summerville, SC 29486-2842
Phone: (843) 352-4454
Fax: (843) 352-4875
Mailing address
1724 State Rd Unit 4d
Summerville, SC 29486-2842
Registry dates
- Enumerated
- 2021-12-07
- Last updated
- 2021-12-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.