Organization
GABRIEL BOUSTANI DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GABRIEL BOUSTANI DMD, MSD (PRESIDENT)
(617) 640-4637
Entity
Organization
Contact information
Practice address
1540 BEACON ST, BROOKLINE, MA 02446-2215
(617) 738-1950
Mailing address
140 GREENWOOD ST, NEWTON, MA 02459-3013
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
21631
MA
Other
Enumeration date
01/20/2015
Last updated
01/23/2015
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