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1629836010
MINA BOULOS
BUFFALO, NY
NPI
1629836010
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-11
Last Update Date
2024-03-11
Business Address
MINA BOULOS DMD
2500 KENSINGTON AVE
BUFFALO, NY 14226-4927
Phone number: 716-437-6453
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Mailing Address
MINA BOULOS DMD
12 CRAWFORD PL
OLD BRIDGE, NJ 08857-3403
Phone number: 732-501-9834
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