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General NPI Number Information
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NPI Number | 1558817486
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Entity Type | Organization
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Legal Business Name | BOYD FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 08/31/2016
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Last Update Date | 08/31/2016
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Provider Practice Location Address
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Address Line | 151 N 3RD ST SUITE 2
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City | DANVILLE
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State | KY
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Zip | 40422-1600
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Country | US
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Telephone | 859-236-8229
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Fax |
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Provider Business Mailing Address
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Address Line | 151 N 3RD ST SUITE 2
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City | DANVILLE
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State | KY
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Zip | 40422-1600
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Country | US
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Telephone | 859-236-8229
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. CHARLES L BOYD
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Credential | DMD
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Telephone | 859-236-8229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9218
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License Number State | KY
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