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General NPI Number Information
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NPI Number | 1306120712
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Entity Type | Organization
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Legal Business Name | SUMMIT DENTAL GROUP LLC
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Dates
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Enumeration Date | 10/04/2011
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 1003 E. TURKEYFOOT LAKE RD. SUITE A
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City | AKRON
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State | OH
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Zip | 44312
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Country | US
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Telephone | 330-896-1959
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Fax | 330-896-8944
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Provider Business Mailing Address
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Address Line | 1003 E. TURKEYFOOT LAKE RD. SUITE A
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City | AKRON
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State | OH
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Zip | 44312
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Country | US
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Telephone | 330-896-1959
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Fax | 330-896-8944
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Authorized Official
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Title or Position | OWNER/ DENTIST
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Name | THOMAS J. BIRONG
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Credential | DDS
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Telephone | 330-627-5666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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