Individual
DR. DWAYNE GAIL SUMMERS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1365 DOUGLAS DR, CARBONDALE, IL 62901-2583
(618) 453-2353
(618) 453-7020
Mailing address
1365 DOUGLAS DR, CARBONDALE, IL 62901-2583
(618) 453-2353
(618) 453-7020
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005432
—
IL
Enumeration date
10/27/2005
Last updated
07/09/2007
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