| NPI | 1578725842 |
|---|---|
| Doing Business As | BOULEVARD DENTAL |
| Entity Type | Organization |
| Authorized Contact | GREG A. HANSON Owner 605-341-1895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SD M514) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |