Individual
LAUREN MICHELLE BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1708 E PASS RD, GULFPORT, MS 39507-3528
(228) 822-9190
(228) 822-9559
Mailing address
1708 E PASS RD, GULFPORT, MS 39507-3528
(228) 822-9190
(228) 822-9559
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3546-10
MS
Other
Enumeration date
10/29/2010
Last updated
10/29/2010
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