Provider Demographics
NPI:1952535304
Name:BOLSTER, JULIE GOSLINE (RDH)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:GOSLINE
Last Name:BOLSTER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 OLD BRUNSWICK RD
Mailing Address - Street 2:
Mailing Address - City:GARDINER
Mailing Address - State:ME
Mailing Address - Zip Code:04345-6038
Mailing Address - Country:US
Mailing Address - Phone:207-582-4939
Mailing Address - Fax:
Practice Address - Street 1:14 MERRILL ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:ME
Practice Address - Zip Code:04344-1622
Practice Address - Country:US
Practice Address - Phone:207-626-3091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2010124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist