Provider Demographics
NPI:1174601009
Name:BOYD, JULIE ANN (DDS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:BOYD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8512 LOCKWOOD PL N
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-6012
Mailing Address - Country:US
Mailing Address - Phone:317-888-9876
Mailing Address - Fax:
Practice Address - Street 1:1030 E COUNTY LINE RD
Practice Address - Street 2:SUITE A 1
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-2932
Practice Address - Country:US
Practice Address - Phone:317-859-6880
Practice Address - Fax:317-859-6882
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009342A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist