Individual
DR. MICHAEL A BOLDRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1014 MADISON ST, ROCHESTER, IN 46975-1830
(574) 223-3312
(574) 224-3312
Mailing address
1014 MADISON ST, ROCHESTER, IN 46975-1830
(574) 223-3312
(574) 224-3312
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007092
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35-1299050-001
ANTHEM
IN
Enumeration date
08/17/2006
Last updated
07/08/2007
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