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General NPI Number Information
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NPI Number | 1780897322
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Entity Type | Organization
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Legal Business Name | MARK E BOSTIC D.D.S.
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 713 COLLEGE ST
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City | OXFORD
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State | NC
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Zip | 27565-2718
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Country | US
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Telephone | 919-693-7635
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Fax | 919-693-8276
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Provider Business Mailing Address
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Address Line | 713 COLLEGE ST
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City | OXFORD
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State | NC
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Zip | 27565-2718
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Country | US
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Telephone | 919-693-7635
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Fax | 919-693-8276
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MARK E BOSTIC
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Credential | DDS
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Telephone | 919-693-7635
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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 | 6318
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License Number State | NC
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