Provider Demographics
NPI:1326434671
Name:M. AUSTIN BOYD DMD PC
Entity Type:Organization
Organization Name:M. AUSTIN BOYD DMD PC
Other - Org Name:BOYD FAMILY DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-655-5105
Mailing Address - Street 1:5891 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-8693
Mailing Address - Country:US
Mailing Address - Phone:205-655-5105
Mailing Address - Fax:205-655-5122
Practice Address - Street 1:5891 VALLEY RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-8693
Practice Address - Country:US
Practice Address - Phone:205-655-5105
Practice Address - Fax:205-655-5122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL47651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty