Provider Demographics
NPI:1346244621
Name:SUMMERHAYS, CAROL GOMEZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:GOMEZ
Last Name:SUMMERHAYS
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 1:6635 FLANDERS DR
Mailing Address - Street 2:STE E
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2978
Mailing Address - Country:US
Mailing Address - Phone:858-457-4100
Mailing Address - Fax:858-457-5200
Practice Address - Street 1:6635 FLANDERS DR
Practice Address - Street 2:STE E
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2978
Practice Address - Country:US
Practice Address - Phone:858-457-4100
Practice Address - Fax:858-457-5200
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-02
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA272871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice