Individual
MR. KELLY B BOSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS 9311
Contact information
Practice address
24000 HWY 7, SUITE 120 KELLY BOSWORTH FAMILY DENTISTRY, SHOREWOOD, MN 55331
(952) 474-4123
(952) 401-3482
Mailing address
24000 HWY 7, SUITE 120 KELLY BOSWORTH FAMILY DENTISTRY, SHOREWOOD, MN 55331
(952) 474-4123
(952) 401-3482
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9311
MN
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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