IndividualActive
Gregory Bouldien, DDS MS
NPI 1013023837 · Orthodontics and Dentofacial Orthopedics Dentistry · Olive Branch, MS
Provider details
- NPI number
- 1013023837
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- DDS MS
- Sex
- Male
- Sole proprietor
- No
- License
- 5213 (TN)
Specialties & taxonomies
Dental Providers
Practice location
9880 Goodman Rd
Olive Branch, MS 38654-1722
Phone: (662) 470-4919
Fax: (662) 874-6295
Approximate (ZIP-level) locationGet directions
Mailing address
9880 Goodman Rd
Olive Branch, MS 38654-1722
Additional practice locations (2)
- 7734 Airways BlvdSouthaven, MS 38671-5306Phone: (662) 349-3838Fax: (662) 349-5923
- 7675 Wolf River Cir Ste 102Germantown, TN 38138-1747Phone: (901) 363-8191Fax: (662) 363-2774
Registry dates
- Enumerated
- 2006-08-22
- Last updated
- 2018-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.