Individual
SAMIRA BOLIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
905 FRANKLIN ST, WATERLOO, IA 50703-4407
(319) 272-4300
Mailing address
905 FRANKLIN ST, WATERLOO, IA 50703-4407
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
03673
IA
124Q00000X
Dental Hygienist
2358
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076372
—
IA
Enumeration date
01/05/2009
Last updated
01/05/2009
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