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Individual

DR. PAUL JOHN BOSCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
494 HIGHLAND AVE, NEWPORT, VT 05855
(802) 334-1400
(802) 334-1809
Mailing address
68 TAMARACK RD, JAY, VT 05859
(802) 988-4357
(802) 988-9625

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0001953
VT
Enumeration date
08/05/2006
Last updated
07/08/2007
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