Individual
DR. JUAN CARLOS BOSQUE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3760 CONVOY ST, SUITE 330, SAN DIEGO, CA 92111-3742
(858) 999-5968
Mailing address
5514 BLOCH ST, SAN DIEGO, CA 92122-4012
(858) 999-5968
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
42723
CA
Other
Enumeration date
04/16/2007
Last updated
01/09/2012
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