| J.c. Boley, D.d.s., M.s., Inc. | |
|
400 S Cottonwood Dr Richardson TX 75080-5708 | |
| (972) 231-4896 | |
| (972) 994-9747 |
| Full Name | J.c. Boley, D.d.s., M.s., Inc. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 400 S Cottonwood Dr, Richardson, Texas |
| Authorized Official Name and Position | Jimmy Carroll Boley (PRESIDENT) |
| Authorized Official Contact | 9722314896 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J.c. Boley, D.d.s., M.s., Inc. 400 S Cottonwood Dr Richardson TX 75080-5708 Ph: (972) 231-4896 | J.c. Boley, D.d.s., M.s., Inc. 400 S Cottonwood Dr Richardson TX 75080-5708 Ph: (972) 231-4896 |
| NPI Number | 1760501944 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760501944 | NPI | - | NPPES |
| 00C652 | Other | TX | BCBSINSURANCE PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 7425 (Texas) | Primary |
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