Individual
DR. MICHAEL ROBERT BOLDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
922 E MAIN ST, MEDFORD, OR 97504-7136
(541) 772-2756
(541) 772-3072
Mailing address
922 E MAIN ST, MEDFORD, OR 97504-7136
(541) 772-2756
(541) 772-3072
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6349
OR
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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