Provider Demographics
NPI:1780733949
Name:BOAZ, DAVID EVERS (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:EVERS
Last Name:BOAZ
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 1:891 WILLOW DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:919-942-7550
Mailing Address - Fax:919-942-6653
Practice Address - Street 1:891 WILLOW DR
Practice Address - Street 2:SUITE 5
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514
Practice Address - Country:US
Practice Address - Phone:919-942-7550
Practice Address - Fax:919-942-6653
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC48791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice