Individual
J. JERALD BOSEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4190 S HIGHLAND DR, SUITE 106, SALT LAKE CITY, UT 84124-2600
(801) 278-0840
(801) 278-8414
Mailing address
4190 HIGHLAND DR, SUITE 106, SALT LAKE CITY, UT 84124-2600
(801) 278-0840
(801) 278-8414
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
140450-9922
UT
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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