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DR. JOHN EDWIN BOLAND D.D.S.

>> Dentist >> Dental Providers

Registrant NPI Number: 1740322767

Individual Registrant:
DR. JOHN EDWIN BOLAND D.D.S.
Gender: M
Sole Proprietor

Location and contact information for practice:
770 TAMALPAIS DR STE 404  CORTE MADERA, CA 94925-1739 US
Tel: 415-927-9052  Fax: 415-927-2231

Contact information for business:
770 TAMALPAIS DR STE 404  CORTE MADERA, CA 94925-1739 US
Tel: 415-927-9052  Fax: 415-927-2231

Registration Information:
NPI: 1740322767
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
CA39515

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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