Provider Demographics
NPI:1003022211
Name:BOLUR, STEVE H (DDS)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:H
Last Name:BOLUR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12113 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WEST LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025
Mailing Address - Country:US
Mailing Address - Phone:310-571-3000
Mailing Address - Fax:310-571-3309
Practice Address - Street 1:12113 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:WEST LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025
Practice Address - Country:US
Practice Address - Phone:310-571-3000
Practice Address - Fax:310-571-3309
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37316122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist