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General NPI Number Information
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NPI Number | 1629602529
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Entity Type | Organization
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Legal Business Name | SUMMIT SMILES PEDIATRIC DENTISTRY, LLC
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Dates
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Enumeration Date | 02/28/2020
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 4213 DOLLY RIDGE RD
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City | VESTAVIA
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State | AL
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Zip | 35243-5703
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Country | US
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Telephone | 205-490-6850
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Fax | 205-449-0292
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Provider Business Mailing Address
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Address Line | 4213 DOLLY RIDGE RD
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City | VESTAVIA
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State | AL
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Zip | 35243-5703
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Country | US
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Telephone | 205-490-6850
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Fax | 205-449-0292
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Authorized Official
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Title or Position | PEDIATRIC DENTIST (PEDODONTIST)
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Name | DR. SEAN CLAUDE GUNNELS
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Credential | DMD
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Telephone | 251-455-9787
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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 |
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License Number State |
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