Individual
DR. BRYANT RIDGWAY BOSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1513 LAKELAND DR, SUITE 201, JACKSON, MS 39216
(601) 366-1242
(601) 366-1275
Mailing address
1513 LAKELAND DR, SUITE 201, JACKSON, MS 39216
(601) 366-1242
(601) 366-1275
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1451 71
MS
Other
Enumeration date
11/22/2006
Last updated
07/08/2007
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