Provider Demographics
NPI:1205720125
Name:BOYD, JUSTIN DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:DAVID
Last Name:BOYD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 PINNACLE DRIVE PO#1084
Mailing Address - Street 2:
Mailing Address - City:BLOWING ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28605
Mailing Address - Country:US
Mailing Address - Phone:704-797-1835
Mailing Address - Fax:
Practice Address - Street 1:120 PINNACLE DRIVE PO#1084
Practice Address - Street 2:
Practice Address - City:BLOWING ROCK
Practice Address - State:NC
Practice Address - Zip Code:28605
Practice Address - Country:US
Practice Address - Phone:704-797-1835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program