Individual ProviderJames Alfred SummittDentistDental ProvidersPractice Address830 N Creek Dr, Conway, AR 72032-4711(501) 932-0559(501) 336-8863PECOS EnrollmentBased on the most recent information from CMS, provider James Alfred Summitt does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1750410569Provider TypeIndividualFull NameSummitt, James AlfredCredentialDDSGenderMaleSole ProprietorNoEnumeration Date3/5/2007Last Updated7/9/2007Contact InformationPractice LocationPractice Address830 N Creek Dr, Conway, AR 72032-4711Phone(501) 932-0559Fax(501) 932-0227Mailing LocationMailing Address1770 Angeline Dr, Conway, AR 72032-8601Phone(501) 336-8863Fax(501) 932-0227Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense2269ArkansasProvider IdentifiersIDDescriptionIssuerID112154608DescriptionMedicaidIssuerUnlistedArkansas