Provider Demographics
NPI:1548012370
Name:JOSH BOYD DMD PLLC
Entity type:Organization
Organization Name:JOSH BOYD DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-349-6579
Mailing Address - Street 1:500 BERRETT AVE
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-7039
Mailing Address - Country:US
Mailing Address - Phone:303-349-6579
Mailing Address - Fax:
Practice Address - Street 1:1800 FLANDRO DR STE 340
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83202-4944
Practice Address - Country:US
Practice Address - Phone:303-349-6579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental