Individual
RUSSELL B BOYTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1630 NW BROAD ST, SUITE 101, MURFREESBORO, TN 37129
(615) 896-0608
(615) 848-9444
Mailing address
1630 NW BROAD ST, SUITE 101, MURFREESBORO, TN 37129
(615) 896-0608
(615) 848-9444
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
005230
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4033615
BLUE CROSS BLUE SHIELD TN
TN
Enumeration date
08/29/2006
Last updated
07/08/2007
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