SUMMIT CITY SMILES NPI 1083080386

NPI Information

NPI: 1083080386
Provider Name: SUMMIT CITY SMILES
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1330 E STATE BLVD
FORT WAYNE, IN
ZIP 46805
Phone: (260) 484-5614
Get Directions

SUMMIT CITY SMILES is a dental clinic center in Fort Wayne, IN. SUMMIT CITY SMILES NPI is 1083080386. The provider is registered as an organization entity type.

The provider's business location address is:

1330 E STATE BLVD
FORT WAYNE, IN
ZIP 46805-422
Phone: (260) 484-5614

The provider's authorized official is Roger Paul Valliere .
The authorized official title is President and has the following contact phone number (260) 484-5614.

The enumeration date for this NPI number is 8/20/2015 and was last updated on 8/20/2015.

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

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