Provider Demographics
NPI:1144473588
Name:BOZARTH, SETH H (DMD)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:H
Last Name:BOZARTH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02841-1006
Mailing Address - Country:US
Mailing Address - Phone:860-694-2914
Mailing Address - Fax:
Practice Address - Street 1:43 SMITH RD
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02841-1006
Practice Address - Country:US
Practice Address - Phone:860-694-2914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57850122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist