Provider Demographics
NPI:1447394218
Name:BRIMBERRY, DOYLE LYNN (DDS)
Entity Type:Individual
Prefix:
First Name:DOYLE
Middle Name:LYNN
Last Name:BRIMBERRY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 N MERIDIAN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112
Mailing Address - Country:US
Mailing Address - Phone:405-942-8507
Mailing Address - Fax:405-942-8508
Practice Address - Street 1:5252 N MERIDIAN
Practice Address - Street 2:SUITE 102
Practice Address - City:OK CITY
Practice Address - State:OK
Practice Address - Zip Code:73112
Practice Address - Country:US
Practice Address - Phone:405-942-8507
Practice Address - Fax:405-942-8508
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK 533511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice