Individual
BASSEL BOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1290 TREMONT ST, ROXBURY, MA 02120-3432
(617) 427-1000
Mailing address
100 BRIDGE ST, PELHAM, NH 03076-3422
(603) 931-4698
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
04520
NH
Other
Enumeration date
10/06/2016
Last updated
09/20/2019
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