| NPI | 1063658631 |
|---|---|
| Former Legal Business Name | SCOTT B. BOLTZ, DDS |
| Entity Type | Organization |
| Authorized Contact | SCOTT B BOLTZ Owner 765-864-2328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IN 12008297A) |
| Enumeration Date | 2009-01-01 |
| Last Update Date | 2009-01-01 |