Individual
DR. MINA BOULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., D.M.D.
Contact information
Practice address
260 OLD HOOK RD BLDG SUITE202, WESTWOOD, NJ 07675-3123
(978) 821-3822
Mailing address
320 ADOLPHUS AVE APT 1411, CLIFFSIDE PARK, NJ 07010-2856
(978) 821-3822
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI03026500
NJ
Other
Enumeration date
04/11/2017
Last updated
08/28/2024
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