Boland, Thomas J

Boland, Thomas J is an individual health care provider with primary practice located at 6540 4Th St N , St Petersburg FL 33702-6822. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Boland, Thomas J can be contacted via phone (727) 525-0155.

Contact Information

Primary practice address
6540 4Th St N St Petersburg FL 33702-6822
Phone: (727) 525-0155
Fax: (727) 520-7173
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X ME0050633 Florida

Profile Details

NPI number 1679531867
LBN Legal business name Boland, Thomas J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Oct 21st, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679531867 NPPES
Florida MEDICAID 046922000

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