Provider Demographics
NPI:1033568381
Name:BOYD, KYLA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KYLA
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KYLA
Other - Middle Name:
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:6012 W TOPEKA DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7694
Mailing Address - Country:US
Mailing Address - Phone:701-391-6149
Mailing Address - Fax:
Practice Address - Street 1:9915 W MCDOWELL RD STE 106
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4897
Practice Address - Country:US
Practice Address - Phone:701-391-6149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD009462122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist