Individual
DR. BRUCE LYNN BOSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
25529 EAST MAIN ST, ONLEY, VA 23418-0345
(757) 787-8811
(757) 787-8812
Mailing address
PO BOX 345, ONLEY, VA 23418-0345
(757) 787-8811
(757) 787-8812
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0401008796
VA
Other
Enumeration date
12/13/2006
Last updated
02/08/2008
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