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Organization
STONEBRIDGE DENTAL
Active
Organization
STONEBRIDGE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL BOLTEN D.D.S. (OWNER/PARTNER)
(972) 547-0554
Entity
Organization
Contact information
Practice address
6633 W ELDORADO PKWY STE 100, MCKINNEY, TX 75070-6185
(972) 547-0554
(972) 547-4865
Mailing address
6633 W ELDORADO PKWY STE 100, MCKINNEY, TX 75070-6185
(972) 547-0554
(972) 547-4865
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
21007
TX
1223G0001X
General Practice Dentistry
21014
TX
1223G0001X
General Practice Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
09/26/2011
Last updated
01/13/2015
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