DR. Chad M Boustany, D.D.S.

NPI #1114182029 in Morgantown, West Virginia

Provider Information

NPI Number: 1114182029
Entity Type: Individual
Name: DR. Chad M Boustany, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Jul 21, 2008
Last Updated: Jul 21, 2008

Practice Location

Address: 152 MEADOWRIDGE TOWNHOMES
City: Morgantown
State: West Virginia
ZIP Code: 26505
Phone: (304) 599-1478

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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