Organization
GREGORY K. BOLLEN, DDS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LISA ANN BROOKS RDH (OFFICE MGR.)
(501) 982-4444
Entity
Organization
Contact information
Practice address
809 MARSHALL RD, JACKSONVILLE, AR 72076-3744
(501) 982-4444
(501) 982-6616
Mailing address
809 MARSHALL RD, JACKSONVILLE, AR 72076-3744
(501) 982-4444
(501) 982-6616
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2890
AR
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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