| Summit Dental Group | |
|
480 N Latah St Boise ID 83706-2630 | |
| (208) 345-8962 | |
| (208) 345-5207 |
| Full Name | Summit Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 480 N Latah St, Boise, Idaho |
| Authorized Official Name and Position | Amy L. Leberman (ADMIN) |
| Authorized Official Contact | 2083458962 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Dental Group 480 N Latah St Boise ID 83706-2630 Ph: (208) 345-8962 | Summit Dental Group 480 N Latah St Boise ID 83706-2630 Ph: (208) 345-8962 |
| NPI Number | 1043343551 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 04/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043343551 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D-1351 (Idaho) | Primary |
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