Individual
DR. CHAD M BOUSTANY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
152 MEADOWRIDGE TOWNHOMES, MORGANTOWN, WV 26505
(304) 599-1478
Mailing address
152 MEADOWRIDGE TOWNHOMES, MORGANTOWN, WV 26505
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3842
WV
Other
Enumeration date
07/21/2008
Last updated
07/21/2008
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