| NPI | 1952768186 |
|---|---|
| Doing Business As | BOULEVARD DENTAL |
| Entity Type | Organization |
| Authorized Contact | MICHAEL H DOERR President 605-341-1895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SD D1092) |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2016-01-19 |