Individual
DR. CATHERINE BOULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1432 FOREST AVE, STATEN ISLAND, NY 10302-2204
(718) 442-9254
Mailing address
131 BARBARA ST, STATEN ISLAND, NY 10306-1827
(718) 980-9472
(718) 980-9472
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
045193-1
NY
Other
Enumeration date
11/15/2008
Last updated
11/15/2008
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