John Patrick Boyle, D.M.D.
Individual provider Active NPI Dentist · Kutztown, PA
NPI 1891857751 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1891857751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS022152L (PA)
- Practice address
- 15295 Kutztown Rd
Kutztown, PA 19530-8706 - Phone
- (610) 683-6955
- Fax
- (610) 683-6954
- NPI assigned
- Dec 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS022152L | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr John P. Boyle, Family Dentistry | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS022152L | PA | Yes |
Addresses
Primary practice location
15295 Kutztown Rd
Kutztown, PA 19530-8706
Mailing address
15295 Kutztown Rd
Kutztown, PA 19530-8706
Phone (610) 683-6955
Other providers in Kutztown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.