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General NPI Number Information
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NPI Number | 1558491837
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Entity Type | Organization
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Legal Business Name | SUMMIT DENTAL ASSOCIATES P.C
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2 PARK AVE
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City | YONKERS
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State | NY
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Zip | 10703-3402
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Country | US
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Telephone | 914-964-8148
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Fax |
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Provider Business Mailing Address
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Address Line | 2 PARK AVE
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City | YONKERS
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State | NY
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Zip | 10703-3402
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA MACDONALD
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Credential |
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Telephone | 914-964-8148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 040105
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License Number State | NY
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