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
ZIP Code
93657-2249
Phone
(559) 875-5538

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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