Provider Demographics
NPI:1548272461
Name:BOYD, CAROLE ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:ANN
Last Name:BOYD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4514 COLE AVE STE 905
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-4184
Mailing Address - Country:US
Mailing Address - Phone:214-521-6261
Mailing Address - Fax:214-521-5474
Practice Address - Street 1:4514 COLE AVE STE 905
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-4184
Practice Address - Country:US
Practice Address - Phone:214-521-6261
Practice Address - Fax:214-521-5474
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX141541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice