Individual
DR. MATTHEW DALTON BOLLAERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3001 41ST ST, MOLINE, IL 61265-7826
(309) 764-1173
Mailing address
3001 41ST ST, MOLINE, IL 61265-7826
(309) 764-1173
(309) 764-3544
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.033745
IL
Other
Enumeration date
08/31/2022
Last updated
08/31/2022
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