Individual
EMILY SUMMERLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
554 KEILY STREET, BUREAU OF MEDICINE AND SURGERY-CENTRALIZED CREDENTIALS, JACKSONVILLE, FL 32212
(757) 953-7011
Mailing address
554 KEILY STREET, BUREAU OF MEDICINE AND SURGERY-CENTRALIZED CREDENTIALS, JACKSONVILLE, FL 32212
(757) 953-7011
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012005A
IN
Other
Enumeration date
10/25/2013
Last updated
10/25/2013
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