Provider Demographics
NPI:1437984424
Name:BOYLE, VINCENT RYAN (DMD, MSD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:RYAN
Last Name:BOYLE
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 PARK AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-2699
Mailing Address - Country:US
Mailing Address - Phone:610-489-6032
Mailing Address - Fax:
Practice Address - Street 1:430 PARK AVE STE 200
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-2699
Practice Address - Country:US
Practice Address - Phone:610-489-6032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0444751223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics