Provider Demographics
NPI:1508398694
Name:BOLIS, SARAH (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:BOLIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7745 MICHAELIS ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-9365
Mailing Address - Country:US
Mailing Address - Phone:352-573-9611
Mailing Address - Fax:
Practice Address - Street 1:3818 N ELM ST STE A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2778
Practice Address - Country:US
Practice Address - Phone:352-573-9611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC134491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice