Provider Demographics
NPI:1326164021
Name:BOLTZ, KARYN C (DDS)
Entity Type:Individual
Prefix:DR
First Name:KARYN
Middle Name:C
Last Name:BOLTZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 BELLOW VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-8586
Mailing Address - Country:US
Mailing Address - Phone:614-873-7022
Mailing Address - Fax:614-873-7033
Practice Address - Street 1:6300 BELLOW VALLEY DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-8586
Practice Address - Country:US
Practice Address - Phone:614-873-7022
Practice Address - Fax:614-873-7033
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0179231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice