| NPI | 1669889903 |
|---|---|
| Former Name | CHERESTINA BOULAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CO 02786251) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 00206493) |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2026-05-26 |