Shaletha M Bolden
Endodontist
1425 Riverstone Pkwy Ste 200
Canton
, Georgia 30114-5611
Shaletha M Bolden
Endodontist
1425 Riverstone Pkwy Ste 200
Canton
, Georgia 30114-5611
(770) 479-0600
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About
Features
Specialties
- Endodontist
Languages spoken
- English
Location
First Address
- Shaletha M Bolden
- 1425 Riverstone Pkwy Suite 200
- Canton, GA
- Zip : 30114
- Phone : (770) 479-0600
Second Address
- Shaletha M Bolden
- 1425 Riverstone Pkwy Ste 200
- Canton, GA
- Zip : 30114-5611
- Phone : (770) 479-0600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 1223E0200X | Endodontist | 27790 | TX |
| N | 1223E0200X | Endodontist | 8802 | TN |
| Y | 1223E0200X | Endodontist | DN015429 | GA |
National Provider Identifier
| NPI | 1013171438 |
|---|---|
| Provider Name | Shaletha M Bolden |
| First Address | Canton, GA 30114 |
| Second Address | Canton, GA 30114-5611 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/07/2008 |
| Last Update Date | 08/09/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.