Provider Demographics
NPI:1306133707
Name:BROYLES, DAWN LOUISE (DDS)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:LOUISE
Last Name:BROYLES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1708
Mailing Address - Country:US
Mailing Address - Phone:513-541-5599
Mailing Address - Fax:513-541-8956
Practice Address - Street 1:1323 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1708
Practice Address - Country:US
Practice Address - Phone:513-541-5599
Practice Address - Fax:513-541-8956
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.023231122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist