Provider Demographics
NPI:1194374801
Name:JOSEPH S BOYLE DDS PA
Entity Type:Organization
Organization Name:JOSEPH S BOYLE DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:BOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-614-8866
Mailing Address - Street 1:7718 LOUIS PASTEUR CT STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3654
Mailing Address - Country:US
Mailing Address - Phone:210-614-8866
Mailing Address - Fax:210-614-0508
Practice Address - Street 1:7718 LOUIS PASTEUR CT STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3654
Practice Address - Country:US
Practice Address - Phone:210-614-8866
Practice Address - Fax:210-614-0508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment