Individual
ALBERTO EDINSON BOLANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4060 PINE RIDGE RD, NAPLES, FL 34119-4011
(239) 304-1974
(239) 304-1974
Mailing address
4060 PINE RIDGE RD, NAPLES, FL 34119-4011
(239) 304-1974
(239) 304-1971
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
053453-1
NY
1223G0001X
General Practice Dentistry
Primary
18041
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02908818
—
NY
Enumeration date
11/21/2007
Last updated
06/11/2019
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