Provider Demographics
NPI:1225475767
Name:BOYLE, KIMBERLY BETH (DDS)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:BETH
Last Name:BOYLE
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 1:8044 GOODLIFE CT
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-7539
Mailing Address - Country:US
Mailing Address - Phone:804-241-7108
Mailing Address - Fax:
Practice Address - Street 1:6366 MECHANICSVILLE TPKE
Practice Address - Street 2:SUITE 205
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-4704
Practice Address - Country:US
Practice Address - Phone:804-569-0530
Practice Address - Fax:804-569-9531
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008705122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist