| NPI | 1730219783 |
|---|---|
| Professional Name | L JACK BOLTON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA MA002685L) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-07-08 |