| Organization Name: | ADVANCED DENTISTRY OF SUMMIT, LLC |
| NPI Number: | 1083910285 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CORINA ATANASE (DENTIST/OWNER) |
| Mailing Address: | 33 Main St Ste. 101 Chatham |
| State: | NJ US |
| Postal Code: | 079282433 |
| Phone Number: | 9736350626 |
| Fax Number: | |
| NPI Enumeration Date: | 02/04/2011 |
| NPI Last Update Date: | 09/14/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 22DI02372900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |