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KENT B BOOZER DDS PA NPI 1508046129


NPI Information

NPI: 1508046129
Provider Name: KENT B BOOZER DDS PA

Doing Business As: BOOZER DENTAL WORKS

Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
5540 OLD JACKSONVILLE HWY
TYLER, TX
ZIP 75703
Phone: (903) 597-2121
Get Directions

KENT B BOOZER DDS PA is a pediatric dentistry dentist in Tyler, TX. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. KENT B BOOZER DDS PA NPI is 1508046129. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Boozer Dental Works.

The provider's business location address is:

5540 OLD JACKSONVILLE HWY
TYLER, TX
ZIP 75703-378
Phone: (903) 597-2121
Fax: (903) 581-7776

The provider's authorized official is Kent B Boozer .
The authorized official title is Dentist/owner and has the following contact phone number (903) 597-2121.

The enumeration date for this NPI number is 11/12/2007 and was last updated on 11/12/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric Dentistry20107TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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