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Contact Information

SUMMIT PARK DENTAL, INC
723 CR 466
LADY LAKE, FL32159
 Phone: 352-430-0543
 Fax: 352-430-0702
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for SUMMIT PARK DENTAL, INC

NPI Number 1053662395
LBN Legal business name SUMMIT PARK DENTAL, INC
Authorized official PHUONG TA - (PRESIDENT / OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/26/2012
Last updated 09/26/2012 - About 14 years ago
Identifiers
FL License # ND14668
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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