Provider Demographics
NPI:1407863954
Name:SUMMERLIN, DOYLE LEONARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:DOYLE
Middle Name:LEONARD
Last Name:SUMMERLIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 E SEMORAN BLVD
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-5602
Mailing Address - Country:US
Mailing Address - Phone:407-889-3553
Mailing Address - Fax:407-886-9680
Practice Address - Street 1:1414 E SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5602
Practice Address - Country:US
Practice Address - Phone:407-889-3553
Practice Address - Fax:407-886-9680
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0082811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice