Provider Demographics
NPI:1689688475
Name:BOYLE, KEVIN C (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:C
Last Name:BOYLE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:222 ROUTE 59
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5204
Mailing Address - Country:US
Mailing Address - Phone:845-357-6780
Mailing Address - Fax:845-357-0323
Practice Address - Street 1:222 ROUTE 59
Practice Address - Street 2:SUITE 211
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5204
Practice Address - Country:US
Practice Address - Phone:845-357-6780
Practice Address - Fax:845-357-0323
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY044933-11223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics