Individual
DR. JOHN P BOLTHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
3100 IVANREST AVE SW, GRANDVILLE, MI 49418-2930
(616) 538-1260
(616) 538-5540
Mailing address
3100 IVANREST AVE SW, GRANDVILLE, MI 49418-2930
(616) 538-1260
(616) 538-5540
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
08554
MI
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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