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Organization

BOLLA, COTTER & ASSOC., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID R BOLLA DDS (CEO)
(810) 982-9821
Entity
Organization

Contact information

Practice address
1125 THOMAS EDISON DR, PORT HURON, MI 48060-8500
(810) 982-9821
(810) 982-9645
Mailing address
1125 THOMAS EDISON DR, PORT HURON, MI 48060-8500
(810) 982-9821
(810) 982-9645

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
014392
MI
1223G0001X
General Practice Dentistry
12328
MI

Other

Enumeration date
11/21/2006
Last updated
05/10/2017
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