DR. John Edwin Boland IV, D.D.S.

NPI #1740322767 in Corte Madera, California

Provider Information

NPI Number: 1740322767
Entity Type: Individual
Name: DR. John Edwin Boland IV, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Feb 13, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 770 TAMALPAIS DR STE 404
City: Corte Madera
State: California
ZIP Code: 94925-1739
Phone: (415) 927-9052

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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