Individual
DR. TIFFANY L BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
755 COMMERCE DR STE 403, DECATUR, GA 30030-2617
(404) 377-1147
(404) 377-7483
Mailing address
755 COMMERCE DR STE 403, DECATUR, GA 30030-2617
(404) 358-6033
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012944
GA
Other
Enumeration date
07/12/2006
Last updated
07/08/2007
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