Individual
JONATHAN BOLESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5940 W UNION HILLS DR, B190, GLENDALE, AZ 85308-1308
(623) 455-5717
Mailing address
5940 W UNION HILLS DR, B190, GLENDALE, AZ 85308-1308
(623) 455-5717
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7387
AZ
Other
Enumeration date
08/29/2007
Last updated
02/21/2011
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