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Marisol Bolivar, DMD,MS
Pediatric Dentist in St Augustine, Florida
NPI 1386991446

Marisol Bolivar is a Pediatric Dentist based in St Augustine, FL and is specialized in Pediatric Dentistry. Marisol Bolivar practices in St Augustine, FL and has the professional credentials of DMD,MS. The NPI Number for Marisol Bolivar is 1386991446 and holds a License No. DN22944 (Florida).

The current practice location address for Marisol Bolivar is 250 Paseo Reyes Dr, St Augustine, FL and can be reached out via phone at 904-429-3387 and via fax at 904-429-3888.

Location: 250 Paseo Reyes Dr, St Augustine, FL, 32095-8462
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386991446
Provider Name
Marisol Bolivar
Credential
DMD,MS
Provider Entity Type
Individual
Gender
Female
Address
250 Paseo Reyes Dr, St Augustine, FL, 32095-8462
Phone Number
904-429-3387
Fax Number
904-429-3888
Provider Enumeration Date
08/08/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
250 Paseo Reyes Dr
City
St Augustine
State
Florida
Zip
32095-8462
Phone Number
904-429-3387
Fax Number
904-429-3888
person
Provider Business Mailing Address Details
Address
250 Paseo Reyes Dr
City
St Augustine
State
Florida
Zip
32095-8462
Phone Number
904-429-3387
Fax Number
904-429-3888
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
DN22944 (Florida)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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