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General NPI Number Information
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NPI Number | 1497157002
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Entity Type | Organization
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Legal Business Name | SUMMER T. WOOD, D.M.D., L.L.C.
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 09/25/2014
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Provider Practice Location Address
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Address Line | 970 N KALAHEO AVE STE C309
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City | KAILUA
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State | HI
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Zip | 96734-1873
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Country | US
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Telephone | 808-254-5503
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Fax |
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Provider Business Mailing Address
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Address Line | 970 N KALAHEO AVE STE C309
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City | KAILUA
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State | HI
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Zip | 96734-1873
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Country | US
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Telephone | 808-254-5503
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUMMER T. WOOD
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Credential | D.M.D.
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Telephone | 808-254-5503
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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 | DT2298
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License Number State | HI
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