Provider Demographics
NPI:1255600839
Name:BOLDING, LAUREN MILLS (DDS)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MILLS
Last Name:BOLDING
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:NICOLE
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:12309 SWEETBOUGH CT
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-4744
Mailing Address - Country:US
Mailing Address - Phone:302-983-5210
Mailing Address - Fax:
Practice Address - Street 1:600 N WOLFE STREET
Practice Address - Street 2:BLALOCK 266
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-6663
Practice Address - Fax:410-614-1089
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14540122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist