IndividualActive
Gary Bouloux, MD, DDS
NPI 1750335733 · Oral & Maxillofacial Surgery (D.M.D.) · Atlanta, GA
Provider details
- NPI number
- 1750335733
- Entity type
- Individual
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Credential
- MD, DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 057350 (GA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1365 Clifton Rd Ne
Atlanta, GA 30322-1013
Phone: (404) 778-5000
Approximate (ZIP-level) locationGet directions
Mailing address
1365b Clifton Rd Ne
Atlanta, GA 30322-1013
Registry dates
- Enumerated
- 2006-05-22
- Last updated
- 2014-11-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.