Provider Demographics
NPI:1023012705
Name:BOYNE, MICHELE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:BOYNE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1562 CONSTITUTION BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3004
Mailing Address - Country:US
Mailing Address - Phone:803-328-8865
Mailing Address - Fax:803-328-8931
Practice Address - Street 1:1562 CONSTITUTION BLVD
Practice Address - Street 2:STE 102
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3004
Practice Address - Country:US
Practice Address - Phone:803-328-8865
Practice Address - Fax:803-328-8931
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC32201223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry