Individual
MRS. MARIA BOUTSIKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
7351 W OAKLAND PARK BLVD, TAMARAC, FL 33319-7107
(954) 742-5055
(954) 742-5341
Mailing address
3480 N PARK RD, HOLLYWOOD, FL 33021-2526
(954) 610-9242
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN19144
FL
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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