Mr Kelly B Bosworth, DDS 9311 is a
Dentist based in Shorewood, Minnesota. Mr Kelly B Bosworth is licensed to practice in Minnesota (license number 9311) and his current practice location is
24000 Hwy 7, Suite 120 Kelly Bosworth Family Dentistry, Shorewood, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(952) 474-4123.
NPI number for Mr Kelly B Bosworth is 1174615306 and his current mailing address is 24000 Hwy 7, Suite 120 Kelly Bosworth Family Dentistry, Shorewood, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1174615306.
Healthcare Provider's Profile
| Full Name | Mr Kelly B Bosworth |
|---|
| Gender | Male |
|---|
| Speciality | Dentist |
|---|
| Location | 24000 Hwy 7, Shorewood, Minnesota |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1174615306
- Provider Enumeration Date: 09/28/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr Kelly B Bosworth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174615306 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 9311 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Kelly B Bosworth is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Kelly B Bosworth, DDS 9311
24000 Hwy 7, Suite 120 Kelly Bosworth Family Dentistry,
Shorewood, MN 55331
Ph: (952) 474-4123 | Mr Kelly B Bosworth, DDS 9311
24000 Hwy 7, Suite 120 Kelly Bosworth Family Dentistry,
Shorewood, MN 55331
Ph: (952) 474-4123 |
Reviews and Comments