Organization
AUGUSTUS M. BOLAND, JR., D.M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUISE B. ROSS (MANAGER)
(803) 258-1193
Entity
Organization
Contact information
Practice address
53 IRVING ST, BARNWELL, SC 29812-1535
(803) 259-1193
(803) 259-1271
Mailing address
53 IRVING ST, BARNWELL, SC 29812-1535
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/17/2009
Last updated
12/17/2009
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