| Kelly Bouchard Dmd Pc | |
|
103 Van Deene Avenue West Springfield MA 01089 | |
| (413) 733-3019 | |
| (413) 788-7387 |
| Full Name | Kelly Bouchard Dmd Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 103 Van Deene Avenue, West Springfield, Massachusetts |
| Authorized Official Name and Position | Kelly Bouchard (OWNER PRESIDENT) |
| Authorized Official Contact | 4137333019 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Bouchard Dmd Pc 103 Van Deene Avenue West Springfield MA 01089 Ph: (413) 733-3019 | Kelly Bouchard Dmd Pc 103 Van Deene Avenue West Springfield MA 01089 Ph: (413) 733-3019 |
| NPI Number | 1821008681 |
|---|---|
| Provider Enumeration Date | 08/08/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821008681 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 20552 (Massachusetts) | Primary |
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