Individual
GREGORY L. BOSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
124 S MAIN ST, SPARTA, TN 38583-2215
(931) 836-2717
Mailing address
124 S MAIN ST, SPARTA, TN 38583-2215
(931) 836-2717
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS2752
TN
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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