Individual
DR. BOLEY JACOB GREENWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
226 N 1100 E, AMERICAN FORK, UT 84003-2054
(801) 756-6037
(801) 756-6088
Mailing address
5860 ALEXIS RD., SYLVANIA, OH 43560
(419) 882-7187
(419) 882-3165
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
6215313-9922
UT
1223P0221X
Pediatric Dentistry
Primary
30-023398
OH
Other
Enumeration date
11/01/2006
Last updated
08/18/2011
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