Boozer, Kent B
Boozer, Kent B is an sole proprietor health care provider with primary practice located at 5540 Old Jacksonville Hwy , Tyler TX 75703-1633. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Boozer, Kent B can be contacted via phone (903) 597-2121.Contact Information
Primary practice address
5540 Old Jacksonville Hwy
Tyler TX 75703-1633
Phone: (903) 597-2121
Fax: (903) 581-7776
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 20107 | Texas |
Profile Details
| NPI number | 1578502878 |
|---|---|
| LBN Legal business name | Boozer, Kent B |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578502878 | NPPES |
| Texas | MEDICAID | 009556401 |
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