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General NPI Number Information
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NPI Number | 1558400937
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Entity Type | Organization
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Legal Business Name | SUMMERHILL FAMILY & COSMETIC DENTISTRY, P.C.
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 281 SUMMERHILL RD SUITE 204
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-4270
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Country | US
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Telephone | 732-698-1070
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Fax | 732-698-9464
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Provider Business Mailing Address
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Address Line | 281 SUMMERHILL RD SUITE 204
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-4270
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Country | US
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Telephone | 732-698-1070
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Fax | 732-698-9464
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Authorized Official
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Title or Position | PRESIDENT - OWNER
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Name | DR. IMAN NAGY GIRGIS
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Credential | DDS
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Telephone | 732-698-1070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D020590
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License Number State | NJ
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