Individual
DR. RICHARD CARL BOLTEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4721 DIXIE HWY, WATERFORD, MI 48329-3522
(248) 673-7026
(248) 673-6989
Mailing address
4721 DIXIE HWY, WATERFORD, MI 48329-3522
(248) 673-7026
(248) 673-6989
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901012575
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901012575
STATE LICENSE
MI
Enumeration date
02/06/2006
Last updated
07/08/2007
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