Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 9428 | CO |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 9428 | CO |
NPI | 1346450111 |
---|---|
Provider Name | Dr. Dorothy Wojtkowski Boisen |
First Address | Montrose, CO 81401-4324 |
Second Address | Montrose, CO 81401-4324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 14/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
75576023 | (05) | CO |