Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | S2-186C | NV |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 58935 | CA |
N | 1223S0112X | Oral and Maxillofacial Surgeon | D6859 | AZ |
NPI | 1033255906 |
---|---|
Provider Name | Dr. Todd Edward Sumner |
First Address | Escondido, CA 92026-3813 |
Second Address | Apo, AA 92778 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 23/11/2021 |