All Medicaid billing entities listing BOLESTA, JONATHAN (OWNER) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Arizona | 1 | $74K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | SHINE AZ LLC | GLENDALE, AZ | Dental Clinic/Center | $74K |