Provider Demographics
NPI:1679003156
Name:BOYD, WILLIAM J JR (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:BOYD
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 BOTANICAL CIR
Mailing Address - Street 2:
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690-7112
Mailing Address - Country:US
Mailing Address - Phone:864-836-3611
Mailing Address - Fax:
Practice Address - Street 1:125 BOTANICAL CIR
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-7112
Practice Address - Country:US
Practice Address - Phone:864-836-3611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9729122300000X
SC109431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist