Provider Demographics
NPI:1902919897
Name:BOYD, RICHARD E (DMD,MS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:BOYD
Suffix:
Gender:M
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 OFFICE PARK CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-5957
Mailing Address - Country:US
Mailing Address - Phone:803-788-7000
Mailing Address - Fax:803-788-4110
Practice Address - Street 1:5 OFFICE PARK CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-5957
Practice Address - Country:US
Practice Address - Phone:803-788-7000
Practice Address - Fax:803-788-4110
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24491223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics