Provider Demographics
NPI:1376702951
Name:BOLES, CATHERINE THORNTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:THORNTON
Last Name:BOLES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:BOLES
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:123 CAPCOM AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-6517
Mailing Address - Country:US
Mailing Address - Phone:919-556-3130
Mailing Address - Fax:
Practice Address - Street 1:123 CAPCOM AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-6517
Practice Address - Country:US
Practice Address - Phone:919-556-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC85671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice