Provider Demographics
NPI:1659055192
Name:J. MICHELE BOYNE, DMD, L.L.C.
Entity Type:Organization
Organization Name:J. MICHELE BOYNE, DMD, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:BOYNE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-328-8865
Mailing Address - Street 1:1562 CONSTITUTION BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3540
Mailing Address - Country:US
Mailing Address - Phone:803-328-8865
Mailing Address - Fax:803-328-8931
Practice Address - Street 1:1562 CONSTITUTION BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3540
Practice Address - Country:US
Practice Address - Phone:803-328-8865
Practice Address - Fax:803-328-8931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty