Provider Demographics
NPI:1982990594
Name:BOLLINGER, STEVEN WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WILLIAM
Last Name:BOLLINGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 518
Mailing Address - Street 2:
Mailing Address - City:ELLETTSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47429-0518
Mailing Address - Country:US
Mailing Address - Phone:812-876-7330
Mailing Address - Fax:812-876-7325
Practice Address - Street 1:5915 W. HIGHWAY 46
Practice Address - Street 2:
Practice Address - City:ELLETTSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47429-0518
Practice Address - Country:US
Practice Address - Phone:812-876-7330
Practice Address - Fax:812-876-7325
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011632A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice