All Medicaid billing entities listing BOULOS, SAMY (DENTIST (DDS)) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Minnesota | 1 | $112K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | BOULOS DENTAL CARE, P.C. | SHOREVIEW, MN | Exclusive Provider Organization | $112K |