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NPI Code Detail

MEDICARE: DR. INNA BOSH D.D.S

MEDICARE:  DR. INNA  BOSH  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
1122300000XDentist033515NY

General Provider Information

NPI Number : 1417179961
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. INNA BOSH D.D.S
Provider Business Mailing Address
First Line : 3698 S. BRISTOL ST.
Second Line :
City : SANTA ANA
State : CA
Zip : 92704
Country : US
Telephone Number : 714-540-8000
Fax Number : 714-540-8008
Provider Business Practice Location Address
First Line : 3698 S BRISTOL ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-7302
Country : US
Telephone Number : 714-540-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 03/17/2017

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Directions to “ DR. INNA BOSH D.D.S” Practice Location

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