MEDICARE: LOUIS WAYNE BOSSOLA DMD

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	DS019164L	PA

General Provider Information

NPI Number	:	1437294154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS WAYNE BOSSOLA DMD

Provider Business Mailing Address
First Line	:	1357 SAXONBURG RD
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-1838
Country	:	US
Telephone Number	:	724-224-3083
Fax Number	:	724-224-2817

Provider Business Practice Location Address
First Line	:	1357 SAXONBURG RD
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-1838
Country	:	US
Telephone Number	:	724-224-3083
Fax Number	:	724-224-2817

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	01/25/2026

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