Provider Demographics
NPI:1962709881
Name:BOSCO, MAY H (RDHAP)
Entity type:Individual
Prefix:MS
First Name:MAY
Middle Name:H
Last Name:BOSCO
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 SANTA ANA AVE
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4236
Mailing Address - Country:US
Mailing Address - Phone:650-892-7811
Mailing Address - Fax:
Practice Address - Street 1:39 SANTA ANA AVE
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-4253
Practice Address - Country:US
Practice Address - Phone:650-892-7811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist