Provider Demographics
NPI:1770845190
Name:CALLIE L DOYLE DMD PLLC
Entity Type:Organization
Organization Name:CALLIE L DOYLE DMD PLLC
Other - Org Name:DOYLE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CALLIE
Authorized Official - Middle Name:LOREN MATTHEWS
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:423-490-7676
Mailing Address - Street 1:5572 LITTLE DEBBIE PKWY
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-4364
Mailing Address - Country:US
Mailing Address - Phone:423-490-7676
Mailing Address - Fax:423-490-9976
Practice Address - Street 1:5572 LITTLE DEBBIE PKWY
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-4364
Practice Address - Country:US
Practice Address - Phone:423-490-7676
Practice Address - Fax:423-490-9976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS92771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty