Individual
JORDAN RANDALL BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2108 W STATE ST, OLEAN, NY 14760-1952
(716) 373-1210
Mailing address
2108 W STATE ST, OLEAN, NY 14760-1952
(716) 373-1210
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
063307
NY
1223G0001X
General Practice Dentistry
063307
NY
Other
Enumeration date
03/28/2022
Last updated
09/07/2023
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