Provider Demographics
NPI:1316057177
Name:BOYLES, FRANKLIN RUSSELL (DDS)
Entity type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:RUSSELL
Last Name:BOYLES
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 1:3930 TANGLEWOOD LANE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762
Mailing Address - Country:US
Mailing Address - Phone:432-366-0896
Mailing Address - Fax:432-366-1486
Practice Address - Street 1:3930 TANGLEWOOD LANE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762
Practice Address - Country:US
Practice Address - Phone:432-366-0896
Practice Address - Fax:432-366-1486
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10570122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA356781OtherUNITED CONCORDIA