Provider Demographics
NPI:1922176312
Name:LINES, RICHARD BOYCE (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BOYCE
Last Name:LINES
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 1:1455 S 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAFFORD
Mailing Address - State:AZ
Mailing Address - Zip Code:85546-4053
Mailing Address - Country:US
Mailing Address - Phone:928-428-5555
Mailing Address - Fax:928-348-6920
Practice Address - Street 1:1455 S 20TH AVE
Practice Address - Street 2:
Practice Address - City:SAFFORD
Practice Address - State:AZ
Practice Address - Zip Code:85546-4053
Practice Address - Country:US
Practice Address - Phone:928-428-5555
Practice Address - Fax:928-348-6920
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD17911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics