Provider Demographics
NPI:1598834830
Name:BOZART, ALBERT T (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:T
Last Name:BOZART
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6132 CAROLINA BEACH ROAD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412
Mailing Address - Country:US
Mailing Address - Phone:910-392-9101
Mailing Address - Fax:910-392-9041
Practice Address - Street 1:6132 CAROLINA BEACH ROAD
Practice Address - Street 2:SUITE 6
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412
Practice Address - Country:US
Practice Address - Phone:910-392-9101
Practice Address - Fax:910-392-9041
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC74101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice