Provider Demographics
NPI:1366580920
Name:BOYDEN, ROBERT D (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:BOYDEN
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 1:11576 S STATE ST STE 1201
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7117
Mailing Address - Country:US
Mailing Address - Phone:801-576-1799
Mailing Address - Fax:801-576-1830
Practice Address - Street 1:11576 S STATE ST STE 1201
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7117
Practice Address - Country:US
Practice Address - Phone:801-576-1799
Practice Address - Fax:801-576-1830
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4760915-9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist