Bolla, Cotter & Assoc., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

014392 Issued in MI

Legal business name

BOLLA, COTTER & ASSOC., P.C.

Practice address

1125 Thomas Edison Dr
Port Huron, MI 48060-8500

Phone

(810) 982-9821

Fax

(810) 982-9645

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David R Bolla, DDS

Title

Ceo

Phone

(810) 982-9821

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1841365624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 THOMAS EDISON DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480608500",
            "telephone_number": "810-982-9821",
            "fax_number": "810-982-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 THOMAS EDISON DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480608500",
            "telephone_number": "810-982-9821",
            "fax_number": "810-982-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLLA, COTTER & ASSOC., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "BOLLA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "810-982-9821",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12328",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "014392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bluewater Pathology PC
• Patricia Blume
• Jennifer Bocek, M. A. CCC-SLP
• Melissa Boggs, MA, BCBA
• Michael Bohne, CRNA
• David R Bolla, D.D.S.
• Karlene Bolman, LMSW
• Sherry Lynn Bombardo, CRNA
• Bone & Joint Institute P C
• Bone & Joint Institute, P.C.

• General Practice Dentistry in Port Huron, MI
• Providers in Port Huron, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.