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General NPI Number Information
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NPI Number | 1932061793
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Entity Type | Organization
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Legal Business Name | SUMMIT DENTAL, PLLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 91 COUNTY RD STE 4
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City | SCARBOROUGH
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State | ME
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Zip | 04074-8203
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Country | US
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Telephone | 207-503-0026
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Fax |
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Provider Business Mailing Address
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Address Line | 87 OWLS NEST RD
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City | PORTLAND
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State | ME
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Zip | 04102-1638
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Country | US
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Telephone | 207-503-0026
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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. SONYA SHAFIQUE
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Credential | DMD
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Telephone | 207-503-0026
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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 |
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License Number State |
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