Individual
JACOB TWYMAN BOYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3450 HIGHWAY 160-491, CORTEZ, CO 81321-9619
(970) 565-7738
(970) 564-1857
Mailing address
3450 HIGHWAY 160-491, CORTEZ, CO 81321-9619
(970) 565-7738
(970) 564-1857
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
415
AK
1223G0001X
General Practice Dentistry
Primary
4363
CO
1223G0001X
General Practice Dentistry
DD2449
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD6279
—
AK
05
—
DDO415
—
AK
05
—
DDO4153
—
AK
05
—
DDO4154
—
AK
05
—
DDO4155
—
AK
Enumeration date
08/30/2006
Last updated
07/09/2007
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