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NPI 1447474580

NPI 1447474580 : ROBERT B BOYD DDS : SOUTH BURLINGTON, VT

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General NPI Number Information
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    NPI Number           |    1447474580
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT B BOYD DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/12/2007
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    Last Update Date     |    07/09/2007
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Provider Practice Location Address
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    Address Line         |    150 DORSET ST SUITE 260
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    City                 |    SOUTH BURLINGTON
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    State                |    VT
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    Zip                  |    05403-6256
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    Country              |    US
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    Telephone            |    802-863-5335
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    Fax                  |    802-863-9087
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Provider Business Mailing Address
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    Address Line         |    150 DORSET ST SUITE 260
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    City                 |    SOUTH BURLINGTON
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    State                |    VT
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    Zip                  |    05403-6256
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    Country              |    US
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    Telephone            |    802-863-5335
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    Fax                  |    802-863-9087
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    1053
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    License Number State |    VT
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