Healthcare Provider Details

I. General information

NPI: 1750303095
Provider Name (Legal Business Name): MICHAEL JOSEPH DOYLE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SCHUSTER RD
JARRETTSVILLE MD
21084-1807
US

IV. Provider business mailing address

911 SAINT ANN DR
STREET MD
21154-1647
US

V. Phone/Fax

Practice location:
  • Phone: 410-692-6132
  • Fax: 410-557-8858
Mailing address:
  • Phone: 410-836-1650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7836
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: