Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Boulos Dental Care, PC

Organization Exclusive Provider Organization · NPI 1023308392

Boulos Dental Care, PC is an Exclusive Provider Organization in Shoreview, Minnesota. Licensed in Minnesota. Registered with an NPI since 2011.

Licensed in
MN
In the registry since
2011
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

470 Highway 96 W Ste 200
Shoreview, MN 55126-1996
Phone: (952) 465-7210
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Exclusive Provider Organization (primary) Taxonomy 302F00000X · Licence 12329 (MN)

Record details

NPI number1023308392
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Samy Boulos — Dentist (Dds) · (952) 465-7210
NPI enumeratedApril 7, 2011
Last updated in NPPESApril 7, 2011
Mailing address110 Carlson Pkwy, Apt #115, Minnetonka, MN 55305-5334

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