Individual
DR. STEPHEN JOHN BOSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1 LAKE ST, SUITE 101, NEW BRITAIN, CT 06052-1396
(860) 223-8107
(860) 223-1086
Mailing address
1 LAKE ST, SUITE 101, NEW BRITAIN, CT 06052-1396
(860) 223-8107
(860) 223-1086
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
006087
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020006087CT01
BS
CT
01
—
07803
CONNECTICARE
CT
Enumeration date
08/12/2006
Last updated
07/08/2007
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