Provider Demographics
NPI:1952508616
Name:BRIAN D. BOYNTON DMD
Entity Type:Organization
Organization Name:BRIAN D. BOYNTON DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BOYNTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-846-0002
Mailing Address - Street 1:10 FOREST FALLS DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6936
Mailing Address - Country:US
Mailing Address - Phone:207-846-0002
Mailing Address - Fax:207-846-0009
Practice Address - Street 1:10 FOREST FALLS DR.
Practice Address - Street 2:SUITE 7
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6936
Practice Address - Country:US
Practice Address - Phone:207-846-0002
Practice Address - Fax:207-846-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME34481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty