Provider Demographics
NPI:1770548240
Name:BOLGER, DAVID T (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:T
Last Name:BOLGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6816 VENTNOR AE
Mailing Address - Street 2:
Mailing Address - City:VENTNOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08406
Mailing Address - Country:US
Mailing Address - Phone:609-823-6100
Mailing Address - Fax:609-823-4336
Practice Address - Street 1:6816 VENTNOR AVE
Practice Address - Street 2:
Practice Address - City:VENTNOR CITY
Practice Address - State:NJ
Practice Address - Zip Code:08406
Practice Address - Country:US
Practice Address - Phone:609-823-6100
Practice Address - Fax:609-823-4336
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01565400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist