Provider Demographics
NPI:1790253615
Name:SUMMIT DENTAL PARTNERS
Entity Type:Organization
Organization Name:SUMMIT DENTAL PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:ROBIN
Authorized Official - Last Name:SCHWARTZ-SACKS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-499-8707
Mailing Address - Street 1:43 OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1508
Mailing Address - Country:US
Mailing Address - Phone:973-216-1992
Mailing Address - Fax:
Practice Address - Street 1:779 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2332
Practice Address - Country:US
Practice Address - Phone:908-499-8707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty