Individual
DR. JOHN G. BOZICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
700 NE MULTNOMAH ST, SUITE 840, PORTLAND, OR 97232-2131
(503) 232-4488
(503) 239-4075
Mailing address
700 NE MULTNOMAH ST, SUITE 840, PORTLAND, OR 97232-2131
(503) 232-4488
(503) 239-4075
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D6611
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159012
—
OR
01
—
D6611
STATE OF OREGON DENTAL
OR
Enumeration date
05/03/2007
Last updated
03/07/2023
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