| Bolla, Cotter & Assoc., P.c. | |
|
1125 Thomas Edison Dr Port Huron MI 48060-8500 | |
| (810) 982-9821 | |
| (810) 982-9645 |
| Full Name | Bolla, Cotter & Assoc., P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1125 Thomas Edison Dr, Port Huron, Michigan |
| Authorized Official Name and Position | David R Bolla (CEO) |
| Authorized Official Contact | 8109829821 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bolla, Cotter & Assoc., P.c. 1125 Thomas Edison Dr Port Huron MI 48060-8500 Ph: (810) 982-9821 | Bolla, Cotter & Assoc., P.c. 1125 Thomas Edison Dr Port Huron MI 48060-8500 Ph: (810) 982-9821 |
| NPI Number | 1841365624 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 05/10/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841365624 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12328 (Michigan) | Secondary |
| 1223G0001X | Dentist - General Practice | 014392 (Michigan) | Primary |
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