MEDICARE: THEODORE TRENT BOZARTH D.D.S.

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	12647	MO
2	1223G0001X	General Practice Dentistry	12647	MO

General Provider Information

NPI Number	:	1134203912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THEODORE TRENT BOZARTH D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 326
Second Line	:
City	:	EL DORADO SPRINGS
State	:	MO
Zip	:	64744-0326
Country	:	US
Telephone Number	:	417-876-6575
Fax Number	:	417-876-6575

Provider Business Practice Location Address
First Line	:	1303 S PARK ST
Second Line	:
City	:	EL DORADO SPRINGS
State	:	MO
Zip	:	64744-2035
Country	:	US
Telephone Number	:	417-876-6575
Fax Number	:	417-876-6575

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	09/11/2025

Similar Medicare Providers

1174617013 — DR. STEVEN SPIVACK DDS
Practice Location Address:

8815 DYER ST STE 210
EL PASO, TX
79904-2035

Practice Phone: 915-755-7697
Practice Fax: 915-751-1056

1427591536 — YUCHI CHANG L.AC.
Practice Location Address:

2033 EDWARDS AVE
SOUTH EL MONTE, CA
91733-2035

Practice Phone: 626-242-6227
Practice Fax:

1861057648 — EL PASO FAMILY DENTAL PLLC
Practice Location Address:

8815 DYER ST STE 210
EL PASO, TX
79904-2035

Practice Phone: 915-755-7697
Practice Fax: 915-751-1056

1467066316 — DR. JERRY KEITH WALKER DDS
Practice Location Address:

8815 DYER ST STE 210
EL PASO, TX
79904-2035

Practice Phone: 915-755-7697
Practice Fax:

1407450083 — MR. RODOLFO SALAZAR JR. CM
Practice Location Address:

6044 GATEWAY BLVD EAST , SUITE 444
EL PASO, TX
79905-2035

Practice Phone: 915-888-7908
Practice Fax: 915-207-1905

1871199380 — ADVANCED CASE MANAGEMENT SERVICES LLC
Practice Location Address:

6044 GATEWAY BLVD EAST , SUITE 444
EL PASO, TX
79905-2035

Practice Phone: 915-888-7908
Practice Fax: 915-207-1905

Directions to “ THEODORE TRENT BOZARTH D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.