Provider Demographics
NPI:1235494519
Name:BOYD, WILLIAM M B (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M B
Last Name:BOYD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-5734
Mailing Address - Country:US
Mailing Address - Phone:706-738-1421
Mailing Address - Fax:706-738-1333
Practice Address - Street 1:1831 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-5734
Practice Address - Country:US
Practice Address - Phone:706-738-1421
Practice Address - Fax:706-738-1333
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0144161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice