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Organization
RICHARD C BOLTEN DDS PC
Active
Organization
RICHARD C BOLTEN DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD CARL BOLTEN DDS (PRESIDENT)
(248) 673-7026
Entity
Organization
Contact information
Practice address
4721 DIXIE HWY, WATERFORD, MI 48329-3565
(248) 673-7026
(248) 673-6989
Mailing address
4721 DIXIE HWY, WATERFORD, MI 48329-3565
(248) 673-7026
(248) 673-6989
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901012575
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901012575
STATE DENTAL LICENSE
MI
Enumeration date
02/27/2007
Last updated
08/22/2020
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