Individual
DR. KEVIN TRAMON BOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
780 E WEST CONNECTOR STE 108, AUSTELL, GA 30106-1349
(770) 702-7850
Mailing address
3805 DALLAS HWY SW STE 806, MARIETTA, GA 30064-1620
(678) 203-3464
(678) 436-8119
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
27791
TX
1223G0001X
General Practice Dentistry
Primary
DN015352
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507574
—
TN
05
—
1513024
—
TN
Enumeration date
07/25/2006
Last updated
02/03/2020
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