Organization
SUMMIT DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER NEILSON JEPPSEN DDS (OWNER)
(479) 524-9379
Entity
Organization
Contact information
Practice address
3860 HIGHWAY 412 E STE F, SILOAM SPRINGS, AR 72761-8499
(479) 524-9379
(479) 524-0976
Mailing address
3860 HIGHWAY 412 E STE F, SILOAM SPRINGS, AR 72761-8499
(479) 524-9379
(479) 524-0976
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3717
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180792608
—
AR
05
—
200268160A
—
OK
Enumeration date
08/05/2013
Last updated
08/05/2013
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