# DONALD A BOURBEAU DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003863952
- **Authorized official:** DR. DONALD ALFRED BOURBEAU DDS (PRESIDENT)
- **Authorized official phone:** (248) 628-4050

## Contact information

- **Practice address:** 837 SOUTH LAPEER ROAD, SUTIE 205, OXFORD, MI 48371-5084
- **Practice address phone:** (248) 628-4050
- **Practice address fax:** (248) 628-4051
- **Mailing address:** PO BOX 640, OXFORD, MI 48371-0640
- **Mailing address phone:** (248) 628-4050
- **Mailing address fax:** (248) 628-4051

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 10939 | MI | Yes |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 08/22/2020