Individual
JARED T BOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
605 RANDOLPH RD, FORT SILL, OK 73503-4535
(580) 442-2263
Mailing address
4301 WILSON ST, FORT SILL, OK 73503-4472
(580) 558-2795
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS043590
PA
Other
Enumeration date
08/01/2022
Last updated
08/01/2022
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