Individual
DR. MICHAEL JOSEPH BOULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DOCTOR OF DENTAL SUR
Contact information
Practice address
134 BRINKERHOFF STREET, PLATTSBURGH, NY 12901
(518) 563-3090
(518) 563-5455
Mailing address
240 JABEZ ALLEN ROAD, PERU, NY 12972
(518) 643-0224
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
48160
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02568803
—
NY
Enumeration date
12/05/2006
Last updated
07/08/2007
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