DEBORA A. BOLTON DDS PA NPI 1104007996

NPI Information

  • NPI: 1104007996
  • Provider Name: DEBORA A. BOLTON, DDS, PA
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Doing Business As: WILLOWDAILE FAMILY DENTISTRY
  • Address: 3823 GUESS RD
    SUITE P
    DURHAM, NC
    ZIP 27705
  • Phone: (919) 479-5800

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NPI Details

DEBORA A. BOLTON, DDS, PA is a general practice dentist in Durham, NC. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DEBORA A. BOLTON, DDS, PA NPI is 1104007996. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Willowdaile Family Dentistry.

The provider's business location address is:

3823 GUESS RD
SUITE P
DURHAM, NC
ZIP 27705-505
Phone: (919) 479-5800
Fax: (919) 620-9244

The provider's authorized official is Debora A Bolton .
The authorized official title is Dentist and has the following contact phone number (919) 479-5800.

The enumeration date for this NPI number is 11/20/2007 and was last updated on 11/20/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice7251NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15900493MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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