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General NPI Number Information
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NPI Number | 1871775429
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Entity Type | Organization
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Legal Business Name | DAVID E. BOAZ DDS
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Dates
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Enumeration Date | 12/05/2007
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 891 WILLOW DR STE 5
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City | CHAPEL HILL
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State | NC
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Zip | 27514-7077
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Country | US
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Telephone | 919-942-7550
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Fax |
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Provider Business Mailing Address
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Address Line | 891 WILLOW DR STE 5
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City | CHAPEL HILL
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State | NC
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Zip | 27514-7077
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Country | US
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Telephone | 919-942-7550
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID E BOAZ
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Credential |
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Telephone | 919-942-7550
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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 | 4879
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License Number State | NC
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