# BOLLA, COTTER & ASSOC., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841365624
- **Authorized official:** MR. DAVID R BOLLA DDS (CEO)
- **Authorized official phone:** (810) 982-9821

## Contact information

- **Practice address:** 1125 THOMAS EDISON DR, PORT HURON, MI 48060-8500
- **Practice address phone:** (810) 982-9821
- **Practice address fax:** (810) 982-9645
- **Mailing address:** 1125 THOMAS EDISON DR, PORT HURON, MI 48060-8500
- **Mailing address phone:** (810) 982-9821
- **Mailing address fax:** (810) 982-9645

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 014392 | MI | Yes |
| 1223G0001X | General Practice Dentistry | 12328 | MI | — |

## Other

- **Enumeration date:** 11/21/2006
- **Last updated:** 05/10/2017