Provider Demographics
NPI:1841342938
Name:SUMMERS, PATRICIA (DDS)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5928 WEST METAIRIE AVENUE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003
Mailing Address - Country:US
Mailing Address - Phone:504-734-9009
Mailing Address - Fax:504-734-8916
Practice Address - Street 1:5928 WEST METAIRIE AVENUE
Practice Address - Street 2:SUITE 2
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003
Practice Address - Country:US
Practice Address - Phone:504-734-9009
Practice Address - Fax:504-734-8916
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA41211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1841218Medicaid