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DR. JOHN EDWIN BOLAND DDS

Pediatric Dentistry >> Dentist >> Dental Providers

Registrant NPI Number: 1992717284

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

Location and contact information for practice:
770 TAMALPAIS DR SUITE 404 CORTE MADERA, CA 94925-1700 US
Tel: 415-927-7711  Fax: --

Contact information for business:
770 TAMALPAIS DR SUITE 404 CORTE MADERA, CA 94925-1700 US
Tel: 415-927-7711  Fax: --

Registration Information:
NPI: 1992717284
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223P0221XDental Providers
Dentist
Pediatric Dentistry
CA22784

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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