# BOSWORTH, INC A DENTAL CORPORATION

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

## Provider details

- **NPI number:** 1285786616
- **Authorized official:** DR. ROBERT L BOSWORTH DDS,MS (OWNER/DENTIST)
- **Authorized official phone:** (858) 292-4566

## Contact information

- **Practice address:** 7675 DAGGET ST, \#160, SAN DIEGO, CA 92111-2200
- **Practice address phone:** (858) 292-4566
- **Practice address fax:** (858) 292-5217
- **Mailing address:** 7675 DAGGET ST, \#160, SAN DIEGO, CA 92111-2200
- **Mailing address phone:** (858) 292-4566
- **Mailing address fax:** (858) 292-5217

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | 55147 | CA | Yes |

## Other

- **Enumeration date:** 01/17/2007
- **Last updated:** 06/07/2016