Individual
DR. EARL BOSTICK SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
110 JACOB SMART BLVD., RIDGELAND, SC 29936
(843) 726-5711
Mailing address
PO BOX 2260, 110 JACOB SMART BLVD., RIDGELAND, SC 29936-2638
(843) 726-5711
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
002311
SC
Other
Enumeration date
07/21/2006
Last updated
07/08/2007
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