Individual provider · NPI-1

Dr. Keith E Boyd, Jr, DDS

Dentist, Periodontics · Bullhead City, AZ

NPI number1275618837
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1275618837
Entity type
Individual (NPI-1)
Name
Dr. Keith E Boyd, Jr
Credential
DDS
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 25, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223P0300X Dentist, Periodontics4121AZYes

Practice location

3003 Highway 95 Ste 103
Bullhead City, AZ 86442-7802

Phone 928-763-5777 · Fax 928-763-6007

Mailing address

2006 Mountain View Loop
Bullhead City, AZ 86426-9299

Phone 928-768-6258 · Fax 928-763-6007

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