Provider Demographics
NPI:1548087166
Name:BOULES BESKALES, MAGY HANY
Entity type:Individual
Prefix:
First Name:MAGY
Middle Name:HANY
Last Name:BOULES BESKALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 WASHINGTON AVE SE APT 507
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-4037
Mailing Address - Country:US
Mailing Address - Phone:612-625-4777
Mailing Address - Fax:
Practice Address - Street 1:716 WASHINGTON AVE SE APT 507
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-4037
Practice Address - Country:US
Practice Address - Phone:612-625-4777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR891122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist