MEDICARE: DR. ROBERT STEPHEN BOH DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	9239	KY
2	390200000X	Student in an Organized Health Care Education/Training Program
3	1223G0001X	General Practice Dentistry	10219	TN

General Provider Information

NPI Number	:	1033483359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT STEPHEN BOH DMD

Provider Business Mailing Address
First Line	:	3127 LONG BLVD APT 308
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2077
Country	:	US
Telephone Number	:	270-839-6608
Fax Number	:

Provider Business Practice Location Address
First Line	:	3127 LONG BLVD APT 308
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203
Country	:	US
Telephone Number	:	270-839-6608
Fax Number	:	270-839-6608

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2012
Last Update Date	:	05/15/2018

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