Individual
DR. KENT B BOOZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5540 OLD JACKSONVILLE HWY, TYLER, TX 75703-1633
(903) 597-2121
(903) 581-7776
Mailing address
117 LINDSEY LN, TYLER, TX 75701-1633
(903) 596-8978
(903) 581-7776
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
20107
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009556401
—
TX
Enumeration date
06/05/2006
Last updated
07/08/2007
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