Individual
DR. MARK ANTHONY BOLDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2323 S. 109TH STREET, SUITE 295, WEST ALLIS, WI 53227
(414) 545-5225
(414) 545-5251
Mailing address
2323 S. 109TH STREET, SUITE 295, WEST ALLIS, WI 53227
(414) 545-5225
(414) 545-5251
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
4290-015
WI
Other
Enumeration date
09/01/2006
Last updated
02/10/2017
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