SUMMIT SQUARE DENTAL LLC NPI 1144764978

NPI Information

NPI: 1144764978
Provider Name: SUMMIT SQUARE DENTAL LLC

Former Legal Business Name: SUMMIT SQUARE DENTISTRY

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
3228 TURNBERRY OAK DR
WAUKESHA, WI
ZIP 53188
Phone: (262) 544-0171
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SUMMIT SQUARE DENTAL LLC is a dental clinic center in Waukesha, WI. SUMMIT SQUARE DENTAL LLC NPI is 1144764978. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Summit Square Dentistry.

The provider's business location address is:

3228 TURNBERRY OAK DR
WAUKESHA, WI
ZIP 53188-969
Phone: (262) 544-0171

The provider's authorized official is Timothy J Mathison .
The authorized official title is President & Ceo and has the following contact phone number (608) 709-8303.

The enumeration date for this NPI number is 12/13/2016 and was last updated on 12/13/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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