Individual
COLE BOUSSELOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3520 UTICA RIDGE RD, BETTENDORF, IA 52722-1620
(563) 359-9165
Mailing address
6841 SUMMERFIELD DR, BETTENDORF, IA 52722-6417
(563) 343-1395
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DDS-10212
IA
Other
Enumeration date
06/07/2024
Last updated
06/07/2024
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