Individual
DANIEL EARL BOLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2817 REILLY ST, FORT BRAGG, NC 28310-7324
(910) 907-6000
Mailing address
121 NEWMAN DR, HERRIN, IL 62948-3528
(618) 727-9044
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019033367
IL
1223G0001X
General Practice Dentistry
Primary
019033367
IL
Other
Enumeration date
08/21/2021
Last updated
05/28/2024
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