Individual
DR. FRED G. BOUSTANY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
36 CHAUNCY ST, BOSTON, MA 02111-2209
(617) 338-5000
(617) 338-1039
Mailing address
36 CHAUNCY ST, BOSTON, MA 02111-2209
(617) 338-5000
(617) 338-1039
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15733
MA
Other
Enumeration date
12/22/2006
Last updated
07/08/2007
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