Provider Demographics
NPI:1669677324
Name:WOOD, SUMMER TOLBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUMMER
Middle Name:TOLBERT
Last Name:WOOD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46-130 KIOWAI ST UNIT 2724
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3676
Mailing Address - Country:US
Mailing Address - Phone:706-394-8349
Mailing Address - Fax:808-941-4836
Practice Address - Street 1:1580 MAKALOA ST
Practice Address - Street 2:SUITE 844
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3237
Practice Address - Country:US
Practice Address - Phone:808-943-0288
Practice Address - Fax:808-625-6269
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT2298122300000X
GADN013529122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist