Healthcare Provider Details

I. General information

NPI: 1306777305
Provider Name (Legal Business Name): KELLY MARIE DOYLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 S COLUMBIA ST
CHAPEL HILL NC
27514-4309
US

IV. Provider business mailing address

7839 WILSON FARM RD
SUMMERFIELD NC
27358-9115
US

V. Phone/Fax

Practice location:
  • Phone: 919-537-3942
  • Fax:
Mailing address:
  • Phone: 248-909-0336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14684
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: