MEDICARE: MAURY COUNTY ENDODONTICS

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	1223E0200X	Endodontics

General Provider Information

NPI Number	:	1205795911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAURY COUNTY ENDODONTICS

Provider Business Mailing Address
First Line	:	1324 TROTWOOD AVE STE 2
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-4750
Country	:	US
Telephone Number	:	931-388-5627
Fax Number	:

Provider Business Practice Location Address
First Line	:	1324 TROTWOOD AVE STE 2
Second Line	:
City	:	COLUMBIA
State	:	TN
Zip	:	38401-4750
Country	:	US
Telephone Number	:	931-388-5627
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	THOMAS BRIAN BOZEMAN
Credential	:
Telephone Number	:	707-529-9029

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “MAURY COUNTY ENDODONTICS ” Practice Location

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