Provider Demographics
NPI:1235344854
Name:BOYLE, JOSEPH SIMON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SIMON
Last Name:BOYLE
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 1:7400 LOUIS PASTEUR DR
Mailing Address - Street 2:#205
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4514
Mailing Address - Country:US
Mailing Address - Phone:210-614-8866
Mailing Address - Fax:210-614-0508
Practice Address - Street 1:7400 LOUIS PASTEUR DR
Practice Address - Street 2:#205
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4514
Practice Address - Country:US
Practice Address - Phone:210-614-8866
Practice Address - Fax:210-614-0508
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX189901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice