Provider Demographics
NPI:1255595070
Name:BOYSE, STUART WAYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:WAYNE
Last Name:BOYSE
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 1:2058 S DOBSON RD STE 3
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-6455
Mailing Address - Country:US
Mailing Address - Phone:480-345-8597
Mailing Address - Fax:480-345-8598
Practice Address - Street 1:2058 S DOBSON RD STE 3
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-6455
Practice Address - Country:US
Practice Address - Phone:480-345-8597
Practice Address - Fax:480-345-8598
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ75731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice