Provider Demographics
NPI:1376620922
Name:BOYLE, JOHN MICHAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:BOYLE
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 1:201 UNION AVE
Mailing Address - Street 2:SUITE1-A
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3002
Mailing Address - Country:US
Mailing Address - Phone:908-526-2113
Mailing Address - Fax:908-526-2337
Practice Address - Street 1:201 UNION AVE
Practice Address - Street 2:SUITE1-A
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3002
Practice Address - Country:US
Practice Address - Phone:908-526-2113
Practice Address - Fax:908-526-2337
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ112461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice