1699855056 NPI number — DR. RICHARD STANLEY BOYES DMD

Table of content: DR. RICHARD STANLEY BOYES DMD (NPI 1699855056)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699855056 NPI number — DR. RICHARD STANLEY BOYES DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOYES
Provider First Name:
RICHARD
Provider Middle Name:
STANLEY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699855056
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 DOS RIOS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREELEY
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80634-9502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-330-3838
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1813 61ST AVE
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
GREELEY
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80634-7994
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-352-4242
Provider Business Practice Location Address Fax Number:
970-352-4246
Provider Enumeration Date:
10/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  0544 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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