Organization
SUMMIT DENTAL HEALTH - BRENTWOOD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE JAMES (CFO)
(502) 254-8504
Entity
Organization
Contact information
Practice address
8041 S 83RD AVE, LA VISTA, NE 68128-2490
(402) 884-1174
Mailing address
134 EVERGREEN RD, SUITE 200, LOUISVILLE, KY 40243-1487
(502) 254-8500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/29/2014
Last updated
07/29/2014
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