Individual
DR. JORDAN CODY BOSEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4190 S HIGHLAND DR, SALT LAKE CITY, UT 84124-2600
(801) 278-0840
Mailing address
4190 S HIGHLAND DR, SALT LAKE CITY, UT 84124-2600
(801) 278-0840
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9418741-9922
UT
Other
Enumeration date
07/15/2015
Last updated
07/15/2015
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