Provider Demographics
NPI:1063711208
Name:SUMMERS, SARAH ELIZABETH SNOW (DMD, MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH SNOW
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 HYDRAULIC RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-8124
Mailing Address - Country:US
Mailing Address - Phone:434-973-3348
Mailing Address - Fax:
Practice Address - Street 1:244 HYDRAULIC RIDGE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-8124
Practice Address - Country:US
Practice Address - Phone:434-973-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401415195204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery