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Organization
SUMMIT DENTAL GROUP
Active
Organization
SUMMIT DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY L. LEBERMAN (ADMIN)
(208) 345-8962
Entity
Organization
Contact information
Practice address
480 N LATAH ST, BOISE, ID 83706-2630
(208) 345-8962
(208) 345-5207
Mailing address
480 N LATAH ST, BOISE, ID 83706-2630
(208) 345-8962
(208) 345-5207
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-1351
ID
Other
Enumeration date
03/13/2007
Last updated
04/04/2016
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