Individual
DR. MONICA LATRISE BOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2600 MILSCOTT DR APT 1234, DECATUR, GA 30033
(917) 716-0899
Mailing address
2600 MILSCOTT DR APT 1234, DECATUR, GA 30033-6020
(917) 716-0899
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9074
NC
1223G0001X
General Practice Dentistry
22D102185700
NJ
1223G0001X
General Practice Dentistry
Primary
DN015502
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
731712172
TAX IDENTIFICATION
NJ
Enumeration date
08/22/2005
Last updated
01/15/2019
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