Provider Demographics
NPI:1497157002
Name:SUMMER T. WOOD, D.M.D., L.L.C.
Entity Type:Organization
Organization Name:SUMMER T. WOOD, D.M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUMMER
Authorized Official - Middle Name:T
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:808-254-5503
Mailing Address - Street 1:970 N KALAHEO AVE STE C309
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1873
Mailing Address - Country:US
Mailing Address - Phone:808-254-5503
Mailing Address - Fax:
Practice Address - Street 1:970 N KALAHEO AVE STE C309
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1873
Practice Address - Country:US
Practice Address - Phone:808-254-5503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT2298122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty