Joseph R. Boulter, D.m.d., M.a.g.d., P.a.
NPI #1225232176 in Jacksonville, Florida
Provider Information
- NPI Number
- 1225232176
- Entity Type
- Organization
- Organization Name
- Joseph R. Boulter, D.m.d., M.a.g.d., P.a.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jun 13, 2007
- Last Updated
- Feb 29, 2012
Practice Location
- Address
- 8823 GOODBYS EXECUTIVE DR
- City
- Jacksonville
- State
- Florida
- ZIP Code
- 32217-4691
- Phone
- (904) 731-0432
Authorized Official
- Name
- DR. JOSEPH ROBERT BOULTER, D.M.D.
- Title
- OWNER
- Phone
- (904) 731-0432
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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