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NPI Code Detail

MEDICARE: GARY WILLIAM SUMNER DDS

MEDICARE: GARY WILLIAM SUMNER DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist37167CA

General Provider Information

NPI Number : 1972615128
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY WILLIAM SUMNER DDS
Provider Business Mailing Address
First Line : 2145 5TH AVE
Second Line :
City : OROVILLE
State : CA
Zip : 95965-5870
Country : US
Telephone Number : 530-534-5394
Fax Number : 530-534-3820
Provider Business Practice Location Address
First Line : 2145 5TH AVE
Second Line :
City : OROVILLE
State : CA
Zip : 95965-5870
Country : US
Telephone Number : 530-534-5394
Fax Number : 530-534-3820
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/21/2022

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