Provider Demographics
NPI:1063603371
Name:ENLOW, SUMMERJOY CHARITY GAMMAGE (DDS)
Entity type:Individual
Prefix:DR
First Name:SUMMERJOY
Middle Name:CHARITY GAMMAGE
Last Name:ENLOW
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SUMMERJOY
Other - Middle Name:CHARITY
Other - Last Name:GAMMAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1329 N UNIVERSITY DR
Mailing Address - Street 2:STE C1
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-4232
Mailing Address - Country:US
Mailing Address - Phone:936-564-9730
Mailing Address - Fax:
Practice Address - Street 1:1329 N UNIVERSITY DR
Practice Address - Street 2:STE C1
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-4232
Practice Address - Country:US
Practice Address - Phone:936-564-9730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0023327122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist