Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 22DI012860 | NJ |
NPI | 1063695146 |
---|---|
Provider Name | Dr. Michael Boyer |
First Address | Toms River, NJ 08753-7643 |
Second Address | Toms River, NJ 08753-6057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2007 |
Last Update Date | 11/12/2007 |