Individual
JERRY BOSTRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1127 WILSHIRE BLVD STE 1504, LOS ANGELES, CA 90017-4006
(213) 201-1388
(213) 201-1398
Mailing address
1127 WILSHIRE BLVD STE 1504, LOS ANGELES, CA 90017-4006
(213) 201-1388
(213) 201-1398
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5044
CA
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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