Individual
THOMAS J BOLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6540 4TH ST N, ST PETERSBURG, FL 33702-6822
(727) 525-0155
(727) 520-7173
Mailing address
6540 4TH ST N, ST PETERSBURG, FL 33702-6822
(727) 525-0155
(727) 520-7173
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
ME0050633
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046922000
—
FL
Enumeration date
05/04/2006
Last updated
10/21/2019
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