Nancy Mary Boutros DDS DOCTOR OF DENTAL

NPI 1063562072 - Dentist - 122300000X

NPI Details
NPI 1063562072
Gender Female
Enumeration Date 01/11/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1381 E LAS JUNAS DR
SUITE #8
SAN GABRIEL CA, 91776, US
Phone (626) 614-5800
Fax (626) 614-9570
Business Location
608 10TH ST
SANTA MONICA CA, 90402, US
Phone (310) 393-2054
Fax (310) 393-2054
Toxanomy
Taxonomy Code 122300000X
License State California
License Number 42809
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According to our database, Dr. Nancy Mary Boutros DDS DOCTOR OF DENTAL NPI is 1063562072, taxonomy code is 122300000X and license number is 42809, license state is located at California. Nancy Mary Boutros DDS DOCTOR OF DENTAL physically located at 1381 E Las Junas Dr, San Gabriel CA, 91776. NPI Number Nancy Mary Boutros DDS DOCTOR OF DENTAL has the Individual type.

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1063562072 NPI number is provided on an as is basis without warranty of any kind. 1063562072 is maintained by the National Plan & Provider Enumeration System. The contents of Nancy Mary Boutros DDS DOCTOR OF DENTAL are for informational purposes only.