MEDICARE: DARRELL LAMAR BOYCE II DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0401418491	VA

General Provider Information

NPI Number	:	1659065936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRELL LAMAR BOYCE II DDS

Provider Business Mailing Address
First Line	:	1711 PARKVIEW DR
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-2630
Country	:	US
Telephone Number	:	757-424-6580
Fax Number	:

Provider Business Practice Location Address
First Line	:	1711 PARKVIEW DR
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-2630
Country	:	US
Telephone Number	:	757-424-6580
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2023
Last Update Date	:	06/08/2023

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