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Individual

DR. MICHAEL LEE BOBO

Active
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Individual

DR. MICHAEL LEE BOBO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS MD

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
34759
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7465 DENTAL
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
34759
KY

Other

Enumeration date
10/25/2006
Last updated
07/12/2012
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