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General NPI Number Information
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NPI Number | 1376681635
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Entity Type | Organization
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Legal Business Name | J. MICHAEL BOYD, D.D.S., INC.
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2813 COFFEE RD SUITE B-2
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City | MODESTO
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State | CA
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Zip | 95355-1755
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Country | US
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Telephone | 209-526-4884
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Fax |
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Provider Business Mailing Address
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Address Line | 2813 COFFEE RD STE B2
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City | MODESTO
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State | CA
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Zip | 95355-1755
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Country | US
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Telephone | 209-526-4884
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. JAMES MICHAEL BOYD
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Credential | D.D.S.
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Telephone | 209-526-4884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 20824
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License Number State | IN
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