Individual
DR. MATTHEW EMIL BOLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
14 LOCKWOOD DR STE A, CHARLESTON, SC 29401-1126
(843) 258-4306
Mailing address
14 LOCKWOOD DR STE A, CHARLESTON, SC 29401-1126
(843) 258-4306
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9833
SC
Other
Enumeration date
07/22/2021
Last updated
09/13/2021
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