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Provider Information for 1063603371

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. SUMMERJOY CHARITY GAMMAGE ENLOW DDS

Other Name:   SUMMERJOY GAMMAGE
Gender: FEMALE

Individual NPI: 1063603371

Calendar   Last Updated:  2014-04-03
  Certification Date: 

Details

Name Value
NPI 1063603371
Enumeration Date 2007-08-05
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1329 N UNIVERSITY DR STE C1
NACOGDOCHES, TX 75961-4232
United States

Phone: 936-564-9730 | Fax:
View Map External Link
Primary Practice Address 1329 N UNIVERSITY DR STE C1
NACOGDOCHES, TX 75961-4232
United States

Phone: 936-564-9730 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist TX 0023327