| Summit Dental, Inc | |
|
1421 Central Avenue Hot Springs AR 71901 | |
| (801) 623-8333 | |
| (501) 623-8331 |
| Full Name | Summit Dental, Inc |
|---|---|
| Speciality | Dentist |
| Location | 1421 Central Avenue, Hot Springs, Arkansas |
| Authorized Official Name and Position | Pamela Renee Halbrook (ADMINISTRATOR) |
| Authorized Official Contact | 5016238333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Dental, Inc 1421 Central Avenue Hot Springs AR 71901 Ph: (501) 623-8333 | Summit Dental, Inc 1421 Central Avenue Hot Springs AR 71901 Ph: (801) 623-8333 |
| NPI Number | 1407172331 |
|---|---|
| Provider Enumeration Date | 04/16/2010 |
| Last Update Date | 10/28/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407172331 | NPI | - | NPPES |
| 112366608 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2967 (Arkansas) | Secondary |
| 122300000X | Dentist | (Arkansas) | Primary |
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