Individual
MARIANA SOLIMAN BOLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
9721 US HIGHWAY 19, PORT RICHEY, FL 34668-7503
(551) 226-0844
Mailing address
167 GROVE ST, LODI, NJ 07644-3027
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02557900
NJ
122300000X
Dentist
DN20972
FL
Other
Enumeration date
06/16/2014
Last updated
11/12/2014
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