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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