# BOYNE CITY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679631923
- **Authorized official:** JOHN REX MORIARITY (OWNER)
- **Authorized official phone:** (231) 582-8000

## Contact information

- **Practice address:** 830 STATE ST, BOYNE CITY, MI 49712
- **Practice address phone:** (231) 582-6644
- **Practice address fax:** (231) 582-6853
- **Mailing address:** PO BOX 368, 830 STATE ST, BOYNE CITY, MI 49712
- **Mailing address phone:** (231) 582-6644
- **Mailing address fax:** (231) 582-6853

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901013182 | MI | Yes |

## Other

- **Enumeration date:** 12/05/2006
- **Last updated:** 08/22/2020