Healthcare Provider Details

I. General information

NPI: 1861954885
Provider Name (Legal Business Name): COLIN B BOSWELL DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 04/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 SOUTH ST
CLAREMONT NH
03743-3180
US

IV. Provider business mailing address

92 SOUTH ST
CLAREMONT NH
03743-3180
US

V. Phone/Fax

Practice location:
  • Phone: 603-543-0455
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. COLIN BOSWELL
Title or Position: OWNER/ DENTIST
Credential: DDS
Phone: 641-780-7792