Individual
DR. BRET A BOLOGNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11039 BROADWAY, SUITE A, CROWN POINT, IN 46307-8834
(219) 663-7193
(219) 663-7833
Mailing address
11039 BROADWAY, SUITE A, CROWN POINT, IN 46307-8834
(219) 663-7193
(219) 663-7833
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009795
IN
Other
Enumeration date
03/20/2007
Last updated
10/16/2012
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