Provider Demographics
NPI:1497809537
Name:DOYLE, MARION GARR (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARION
Middle Name:GARR
Last Name:DOYLE
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 1:624 W DUE WEST AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-4402
Mailing Address - Country:US
Mailing Address - Phone:615-865-9400
Mailing Address - Fax:615-865-9570
Practice Address - Street 1:624 W DUE WEST AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-4402
Practice Address - Country:US
Practice Address - Phone:615-865-9400
Practice Address - Fax:615-865-9570
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS21541223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics