Individual
KRISTINA BOSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
14432 HULL STREET RD, CHESTERFIELD, VA 23832
(804) 318-3218
Mailing address
14432 HULL STREET RD, CHESTERFIELD, VA 23832
(571) 265-1419
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401417064
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401417064
VIRGINIA BOARD OF DENTISTRY
VA
Enumeration date
07/22/2020
Last updated
12/18/2023
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