Individual
DR. MARK BUBOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
9801 DUPONT AVE S, SUITE 200, BLOOMINGTON, MN 55431-3100
(952) 888-5800
Mailing address
9801 DUPONT AVE S, SUITE 425, BLOOMINGTON, MN 55431-3100
(952) 888-5800
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
3376
MN
Other
Enumeration date
06/03/2014
Last updated
06/11/2014
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