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General NPI Number Information
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NPI Number | 1578529384
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Entity Type | Individual
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Provider Name | MOUNA A BOSLER DDS
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Gender | Female
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 12/27/2010
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Provider Practice Location Address
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Address Line | 3000 TWO NOTCH RD
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City | COLUMBIA
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State | SC
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Zip | 29204-2822
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Country | US
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Telephone | 803-691-9930
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Fax |
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Provider Business Mailing Address
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Address Line | 201 W 8TH ST SUITE 810
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City | PUEBLO
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State | CO
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Zip | 81003-3038
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Country | US
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Telephone | 719-562-4447
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3753
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License Number State | SC
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