Provider Demographics
NPI:1215198858
Name:BOYD, ANTHONY LOGAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:LOGAN
Last Name:BOYD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 BAY RIDGE RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-3999
Mailing Address - Country:US
Mailing Address - Phone:410-626-1797
Mailing Address - Fax:410-626-9809
Practice Address - Street 1:914 BAY RIDGE RD
Practice Address - Street 2:SUITE 205
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403-3999
Practice Address - Country:US
Practice Address - Phone:410-626-1797
Practice Address - Fax:410-626-9809
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8580122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist