# SUMMIT DENTAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SUMMIT DENTAL, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1720417314
- **Legal business name:** SUMMIT DENTAL, INC.
- **Authorized official:** PAM HALBROOK (ADMINISTRATOR)
- **Authorized official phone:** (501) 227-0500

## Contact information

- **Practice address:** 12120 COL GLENN RD, SUITE 6600, LITTLE ROCK, AR 72210-2824
- **Practice address phone:** (501) 227-0500
- **Practice address fax:** (501) 227-0503
- **Mailing address:** 12120 COL GLENN RD, SUITE 6600, LITTLE ROCK, AR 72210-2824
- **Mailing address phone:** (501) 227-0500
- **Mailing address fax:** (501) 227-0503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3917 | AR | Yes |

## Other

- **Enumeration date:** 11/05/2013
- **Last updated:** 11/05/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1780939678 | LICENSE 3917 | AR |