Summit Dental Group

NPI #1043343551 in Boise, Idaho

Provider Information

NPI Number: 1043343551
Entity Type: Organization
Organization Name: Summit Dental Group
Primary Specialty: Dentist
Enumeration Date: Mar 13, 2007
Last Updated: Apr 4, 2016

Practice Location

Address: 480 N LATAH ST
City: Boise
State: Idaho
ZIP Code: 83706-2630
Phone: (208) 345-8962

Authorized Official

Name: AMY L. LEBERMAN
Title: ADMIN
Phone: (208) 345-8962

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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