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Contact Information

MARK A BOLDT, DDS
2323 S. 109TH STREET
SUITE 295
WEST ALLIS, WI53227
 Phone: 414-545-5225
 Fax: 414-545-5251
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prosthodontics

1223P0700X
Indicates primary specialty

NPI Profile & details for MARK A BOLDT · (Male)

NPI # 1831291996
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 09/01/2006
Last updated 02/10/2017 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 4290-015
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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