Provider Demographics
NPI:1285753343
Name:BOYER, ROBERT OWEN (DDS MAGD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:OWEN
Last Name:BOYER
Suffix:
Gender:M
Credentials:DDS MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6783 REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-2404
Mailing Address - Country:US
Mailing Address - Phone:801-966-2090
Mailing Address - Fax:
Practice Address - Street 1:6783 REDWOOD RD
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-2404
Practice Address - Country:US
Practice Address - Phone:801-966-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1356111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice