Provider Demographics
NPI:1962759951
Name:BOYLE, STEVEN STANLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:STANLEY
Last Name:BOYLE
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 1:4587 1ST ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-3898
Mailing Address - Country:US
Mailing Address - Phone:801-787-9583
Mailing Address - Fax:
Practice Address - Street 1:631 W 25TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-2814
Practice Address - Country:US
Practice Address - Phone:209-388-9187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61362122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist