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General NPI Number Information
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NPI Number | 1073449302
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Entity Type | Individual
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Provider Name | JOSHUA BOLAND
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Gender | Male
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 620 OHIO AVE
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City | LYNN HAVEN
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State | FL
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Zip | 32444-1756
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Country | US
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Telephone | 850-265-8983
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Fax |
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Provider Business Mailing Address
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Address Line | 220 SEA SOUND CIR APT 2410
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-2639
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN32018
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License Number State | FL
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