Individual
MAURICE MARCUS BOSTICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
27949 JUBAN RD, DENHAM SPRINGS, LA 70726-7915
(504) 417-0582
Mailing address
27949 JUBAN RD, DENHAM SPRINGS, LA 70726-7915
(504) 417-0582
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6545
LA
Other
Enumeration date
05/19/2015
Last updated
05/19/2015
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