Bruce P Bolen DMD LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN12934 Issued in MA

Legal business name

BRUCE P BOLEN DMD LLC

Practice address

2 Hooper St
Marblehead, MA 01945-3213

Phone

(781) 631-3799

NPI assigned

Mar 5, 2014

Last updated

Mar 5, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bruce P Bolen

Title

Owner

Phone

(781) 631-3799

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393977600000",
    "number": "1750707493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HOOPER ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019453213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HOOPER ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019453213",
            "telephone_number": "781-631-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE P BOLEN DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-05",
        "last_updated": "2014-03-05",
        "status": "A",
        "authorized_official_last_name": "BOLEN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-631-3799",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MA",
            "license": "DN12934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelley Springer Braun, RPT
• Lisa Bray-Sinclair, LICSW
• Joan Mary Brennan, RN
• Sarah Joanne Broderick
• Jessica Brown, CCC-SLP
• Kate H Burns, LICSW
• Stephanie Renee Byrne
• Jennifer Calechman, MFTI
• Michael Capps, DPT, GCS
• Alison Leigh Carey

• Dental Clinic/Center in Marblehead, MA
• Providers in Marblehead, MA by specialty
• Dental Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.