| Amanda B. Boltwood Dds Pllc | |
|
2490 Walton Blvd Suite 202 Rochester Hills MI 48309-1484 | |
| (248) 656-2244 | |
| (248) 656-0225 |
| Full Name | Amanda B. Boltwood Dds Pllc |
|---|---|
| Speciality | Dentist |
| Location | 2490 Walton Blvd, Rochester Hills, Michigan |
| Authorized Official Name and Position | Amanda Brianne Boltwood (OWNER) |
| Authorized Official Contact | 2486562244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda B. Boltwood Dds Pllc 2490 Walton Blvd Suite 202 Rochester Hills MI 48309-1484 Ph: (248) 656-2244 | Amanda B. Boltwood Dds Pllc 2490 Walton Blvd Suite 202 Rochester Hills MI 48309-1484 Ph: (248) 656-2244 |
| NPI Number | 1841606332 |
|---|---|
| Provider Enumeration Date | 07/07/2014 |
| Last Update Date | 07/07/2014 |
| Medicare PECOS PAC ID | 5092933994 |
|---|---|
| Medicare Enrollment ID | O20140905000516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841606332 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901019600 (Michigan) | Primary |
| Provider Name | Amanda B Boltwood |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1225231616 PECOS PAC ID: 2264650175 Enrollment ID: I20140905000677 |
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