Individual
DR. BOLIVAR LUPERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 W COURT SQ STE 325, DECATUR, GA 30030-2576
(470) 568-2781
Mailing address
1 W COURT SQ STE 325, DECATUR, GA 30030-2576
(470) 568-2781
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013214
GA
1223P0700X
Prosthodontics
DN013214
GA
Other
Enumeration date
12/18/2006
Last updated
10/13/2025
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