Healthcare Provider Details

I. General information

NPI: 1083832315
Provider Name (Legal Business Name): PATRICIA J BOZZA D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 HEPBURN ST
WILLIAMSPORT PA
17701-6122
US

IV. Provider business mailing address

471 HEPBURN ST
WILLIAMSPORT PA
17701-6122
US

V. Phone/Fax

Practice location:
  • Phone: 570-567-5400
  • Fax:
Mailing address:
  • Phone: 570-567-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS037699
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DIO1882900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: