Provider Demographics
NPI:1740406677
Name:BOYD, RICHARD WALLACE JR (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WALLACE
Last Name:BOYD
Suffix:JR
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:4645 SWEETWATER BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3017
Mailing Address - Country:US
Mailing Address - Phone:281-980-3900
Mailing Address - Fax:281-980-6560
Practice Address - Street 1:4645 SWEETWATER BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3017
Practice Address - Country:US
Practice Address - Phone:281-980-3900
Practice Address - Fax:281-980-6560
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TX111581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics