Dr Russell Lynn Boulton, DDS in Holladay, UT - Medicare Dentist Provider

Dr Russell Lynn Boulton, DDS is a medicare enrolled "Dentist - General Practice" provider in Holladay, Utah. His current practice location is 2180 E 4500 S, #275, Holladay, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 277-9681.

Dr Russell Lynn Boulton is licensed to practice in Utah (license number 131570) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1770709511.

Contact Information

	Dr Russell Lynn Boulton, DDS
	2180 E 4500 S, #275, Holladay, UT 84117-4434
	(801) 277-9681
	Not Available

Healthcare Provider's Profile

Full Name	Dr Russell Lynn Boulton
Gender	Male
Speciality	Dentist - General Practice
Location	2180 E 4500 S, Holladay, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1770709511
Provider Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 0446549018
Enrollment ID: I20160520001325

Medical Identifiers

Medical identifiers for Dr Russell Lynn Boulton such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770709511	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	131570 (Utah)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Russell Lynn Boulton is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Russell Lynn Boulton, DDS 2180 E 4500 S, #275, Holladay, UT 84117-4434 Ph: (801) 277-9681	Dr Russell Lynn Boulton, DDS 2180 E 4500 S, #275, Holladay, UT 84117-4434 Ph: (801) 277-9681

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Dentist in Holladay, UT

Dr. Ralph T Larsen, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1949 E 5600 S, Holladay, UT 84121 Phone: 801-277-8395 Fax: 801-277-5443
Dr. Bradley Stephen Walker, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1434 E 4500 S Ste 102, Holladay, UT 84117 Phone: 801-273-5632
David L Christensen, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 6065 Highland Dr, Suite 1, Holladay, UT 84121 Phone: 801-277-5181 Fax: 801-277-6791
Dr. David S Cannon, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1434 E 4500 S, #202, Holladay, UT 84117 Phone: 801-274-8889 Fax: 801-274-3896
Dr. Jeffrey A. Hill, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 6556 S Big Cottonwood Canyon Rd, Suite 500, Holladay, UT 84121 Phone: 801-943-4200 Fax: 801-943-3675
Dr. Andrew Johansen, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 4970 S 900 E Ste B, Holladay, UT 84117 Phone: 801-261-2013
Dennis Scott Elder, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 4110 Highland Dr, Holladay, UT 84124 Phone: 801-278-8800 Fax: 801-274-0124

Dr Russell Lynn Boulton, DDS - Medicare Dentist in Holladay, UT