Provider Demographics
NPI:1699756502
Name:ROULEAU, CHRISTIAN F (DMD MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:F
Last Name:ROULEAU
Suffix:
Gender:M
Credentials:DMD MD
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Mailing Address - Street 1:167 YACHT CLUB WAY APT 108
Mailing Address - Street 2:
Mailing Address - City:HYPOLUXO
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6061
Mailing Address - Country:US
Mailing Address - Phone:561-313-8161
Mailing Address - Fax:561-278-0721
Practice Address - Street 1:255 GEORGE BUSH BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-4063
Practice Address - Country:US
Practice Address - Phone:561-278-2388
Practice Address - Fax:561-278-0721
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2023-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA7406208600000X
FL185411223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery