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NPI Code Detail

MEDICARE: DR. NICOLE WILL BOLLINGER DMD

MEDICARE:  DR. NICOLE WILL BOLLINGER  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDEN4489ME
21223G0001XGeneral Practice DentistryDDS102197CA

General Provider Information

NPI Number : 1558712083
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLE WILL BOLLINGER DMD
Provider Business Mailing Address
First Line : 3779 E CASTRO VALLEY BLVD
Second Line :
City : CASTRO VALLEY
State : CA
Zip : 94552-4835
Country : US
Telephone Number : 650-759-3294
Fax Number :
Provider Business Practice Location Address
First Line : 3779 E CASTRO VALLEY BLVD
Second Line :
City : CASTRO VALLEY
State : CA
Zip : 94552-4835
Country : US
Telephone Number : 650-759-3294
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2016
Last Update Date : 03/17/2018

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Directions to “ DR. NICOLE WILL BOLLINGER DMD” Practice Location

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