Individual
DR. MICHAEL G. SUMMERS
Active
Individual
DR. MICHAEL G. SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D-3284-OR
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6G405
BLUE CROSS OF ID
ID
01
—
6G421
BLUE CROSS OF IDAHO
ID
01
—
963311
UCCI
ID
Enumeration date
04/11/2007
Last updated
07/08/2007
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