Individual
DR. JODY BOSEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4698 S HIGHLAND DR STE 200, SALT LAKE CITY, UT 84117-5265
(801) 278-0840
(801) 278-8414
Mailing address
4698 S HIGHLAND DR STE 200, SALT LAKE CITY, UT 84117-5265
(801) 278-0840
(801) 278-8414
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
142399
UT
Other
Enumeration date
12/10/2014
Last updated
07/01/2020
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