Provider Demographics
NPI:1548430895
Name:SUMMIT DENTAL, PLLC
Entity Type:Organization
Organization Name:SUMMIT DENTAL, PLLC
Other - Org Name:SCOTT C. DONER DDS PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:C
Authorized Official - Last Name:DONER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-228-7878
Mailing Address - Street 1:248 PLEASANT ST
Mailing Address - Street 2:SUITE 202, PILLSBURY MEDICAL BUILDING
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2588
Mailing Address - Country:US
Mailing Address - Phone:603-228-7878
Mailing Address - Fax:603-228-7654
Practice Address - Street 1:248 PLEASANT ST
Practice Address - Street 2:SUITE 202, PILLSBURY MEDICAL BUILDING
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2588
Practice Address - Country:US
Practice Address - Phone:603-228-7878
Practice Address - Fax:603-228-7654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH21791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30312622Medicaid