Individual
DR. TARA BROOKE BOSHNACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4955 S DURANGO DR, 201, LAS VEGAS, NV 89113
(702) 933-7275
Mailing address
2866 LOVELAND DR, UNIT 2036, LAS VEGAS, NV 89109-0227
(516) 509-5031
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
056092
NY
122300000X
Dentist
Primary
6271
NV
122300000X
Dentist
DN19585
FL
Other
Enumeration date
10/11/2012
Last updated
10/07/2014
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