Individual
DR. MARK MINA BOULES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2771 E LINCOLN HWY, COATESVILLE, PA 19320-2461
(610) 383-1600
Mailing address
1 COTTON ST APT 331, PHILADELPHIA, PA 19127-1557
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS041555
PA
Other
Enumeration date
03/05/2018
Last updated
03/05/2018
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