Provider Demographics
NPI:1023471802
Name:BOYLE, SUZANNE (DMD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:BOYLE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4407
Mailing Address - Country:US
Mailing Address - Phone:301-696-0111
Mailing Address - Fax:301-696-8179
Practice Address - Street 1:182 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 205
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4407
Practice Address - Country:US
Practice Address - Phone:301-696-0111
Practice Address - Fax:301-696-8179
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9447122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist