Individual
GREGORY BOLDEN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021454
MI
Other
Enumeration date
08/13/2014
Last updated
10/16/2015
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