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General NPI Number Information
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NPI Number | 1578669446
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Entity Type | Organization
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Legal Business Name | DAVID C BOYLES JR DDS PC
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 216 S JOHNSON ST
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City | ALVIN
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State | TX
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Zip | 77511-2153
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Country | US
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Telephone | 281-331-1223
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Fax | 281-585-5586
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Provider Business Mailing Address
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Address Line | PO BOX 1467 216 S JOHNSON
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City | ALVIN
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State | TX
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Zip | 77511
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Country | US
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Telephone | 281-331-1223
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Fax | 281-585-5586
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Authorized Official
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Title or Position | DENTIST PRESIDENT
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Name | DR. DAVID C BOYLES JR.
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Credential | DDS PRESIDENT OF COR
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Telephone | 281-331-1223
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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 | 22656
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5717
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 11708
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License Number State | TX
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