National Provider Identifier Database

GARY F BOULOUX, MD, DDS – NPI #1750335733
Oral & Maxillofacial Surgery


Contact Information

GARY F BOULOUX, MD, DDS
1365 CLIFTON RD NE
ATLANTA, GA30322-1013
Phone: 404-778-5000
Fax:
Website:
Specialty Taxonomy Code
* Oral & Maxillofacial Surgery 204E00000X

* Indicates primary specialty

NPI Profile & details for GARY F BOULOUX

NPI Number 1750335733
Credentials MD, DDS
Entity Individual
Enumeration date 05/22/2006
Last updated 11/14/2014 - About 12 years ago
Sole proprietor1 No
Identifiers
  • GA License #: 057350
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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