Kelly V Boulom, DDS
NPI #1821169038 in Sanger, California
Provider Information
- NPI Number
- 1821169038
- Entity Type
- Individual
- Name
- Kelly V Boulom, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Nov 10, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 2432 JENSEN AVE
- City
- Sanger
- State
- California
- ZIP Code
- 93657-2249
- Phone
- (559) 875-5538
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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