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Organization
JERRY L. BOSHELL, D.M.D., P.C.
Active
Organization
JERRY L. BOSHELL, D.M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY L. BOSHELL D.M.D., PH.D. (PRESIDENT)
(205) 221-2330
Entity
Organization
Contact information
Practice address
1606 6TH AVE S, JASPER, AL 35501-4640
(205) 221-2330
(205) 221-3961
Mailing address
1606 6TH AVE S, P.O. BOX 3125, JASPER, AL 35501-4640
(205) 221-2330
(205) 221-3961
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3149
AL
Other
Enumeration date
02/27/2008
Last updated
02/27/2008
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