Individual
DR. ADAM BOUSTANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2017 E PIKE ST, CLARKSBURG, WV 26301-6013
(304) 623-9188
Mailing address
241 RAVEN RUN, MORGANTOWN, WV 26508-9297
(304) 941-7720
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4338
WV
Other
Enumeration date
06/18/2018
Last updated
05/13/2021
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