Provider Demographics
NPI:1447457874
Name:BOHEN, WILLIAM JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAMES
Last Name:BOHEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3723 SE STARBOARD LN
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-6136
Mailing Address - Country:US
Mailing Address - Phone:772-283-4221
Mailing Address - Fax:772-283-7163
Practice Address - Street 1:5761 SE FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-8545
Practice Address - Country:US
Practice Address - Phone:772-287-8225
Practice Address - Fax:772-287-8226
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6297122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist