Individual
DR. RAISON SUJAI BOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2600 N MAYFAIR RD, SUITE 240, WAUWATOSA, WI 53226-1309
(414) 258-1500
(414) 258-9353
Mailing address
2600 N MAYFAIR RD, SUITE 240, WAUWATOSA, WI 53226-1309
(414) 258-1500
(414) 258-9353
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
6750-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UTSA 887X
TEXAS STATE BOARD OF DENTAL EXAMINERS
TX
Enumeration date
08/06/2009
Last updated
04/18/2012
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