DR. Russell Lynn Boulton, DDS

NPI #1770709511 in Holladay, Utah

Provider Information

NPI Number: 1770709511
Entity Type: Individual
Name: DR. Russell Lynn Boulton, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Apr 18, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 2180 E 4500 S
Address 2: #275
City: Holladay
State: Utah
ZIP Code: 84117-4434
Phone: (801) 277-9681

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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