Individual
DR. SCOTT MARLIN BOSACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
206 E MAIN ST, LAKE MILLS, IA 50450-1410
(641) 592-1100
(641) 592-1103
Mailing address
206 E MAIN ST, LAKE MILLS, IA 50450-1410
(641) 592-1100
(641) 592-1103
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6602
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00402610
—
IA
Enumeration date
11/08/2006
Last updated
07/09/2007
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