Richard Lee Bostyan DDS MD

NPI 1194835991 - Dentist - 1223X0400X

NPI Details
NPI 1194835991
Gender Male
Enumeration Date 08/30/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
4554 CLYDE MORRIS BLVD
BUILDING 2
PORT ORANGE FL, 32129-7455, US
Phone (386) 760-5077
Fax (386) 760-5423
Business Location
4554 CLYDE MORRIS BLVD
BUILDING 2
PORT ORANGE FL, 32129-7455, US
Phone (386) 760-5077
Fax (386) 760-5423
Toxanomy
Taxonomy Code 1223X0400X
License State Florida
License Number 3900
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According to our database, Richard Lee Bostyan DDS MD NPI is 1194835991, taxonomy code is 1223X0400X and license number is 3900, license state is located at Florida. Richard Lee Bostyan DDS MD physically located at 4554 Clyde Morris Blvd, Port Orange FL, 32129-7455. NPI Number Richard Lee Bostyan DDS MD has the Individual type.

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1194835991 NPI number is provided on an as is basis without warranty of any kind. 1194835991 is maintained by the National Plan & Provider Enumeration System. The contents of Richard Lee Bostyan DDS MD are for informational purposes only.