Dr. Gregory Bouldien
Orthodontists
9880 Goodman Rd
Olive Branch
, Mississippi 38654-1722
Dr. Gregory Bouldien
Orthodontists
9880 Goodman Rd
Olive Branch
, Mississippi 38654-1722
(662) 874-6295
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About
Features
Specialties
- Orthodontists
Languages spoken
- English
Location
First Address
- Dr. Gregory Bouldien
- 9880 Goodman Rd
- Olive Branch, MS
- Zip : 38654-1722
- Fax : (662) 874-6295
- Phone : (662) 470-4919
Second Address
- Dr. Gregory Bouldien
- 9880 Goodman Rd
- Olive Branch, MS
- Zip : 38654-1722
- Fax : (662) 874-6295
- Phone : (662) 470-4919
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223X0400X | Orthodontists | 5213 | TN |
National Provider Identifier
| NPI | 1013023837 |
|---|---|
| Provider Name | Dr. Gregory Bouldien |
| First Address | Olive Branch, MS 38654-1722 |
| Second Address | Olive Branch, MS 38654-1722 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/08/2006 |
| Last Update Date | 17/03/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.