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Organization
MICHAEL J BOUDREAUX DDS
Active
Organization
MICHAEL J BOUDREAUX DDS
Active
Other names
Park Avenue Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JOSEPH BOUDREAUX DDS (OWNER)
(985) 209-9338
Entity
Organization
Contact information
Practice address
6860 W PARK AVE, SUITE A, HOUMA, LA 70364-2623
(985) 209-9338
Mailing address
6860 W PARK AVE, SUITE A, HOUMA, LA 70364-2623
(985) 209-9338
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5906
LA
Other
Enumeration date
03/01/2012
Last updated
03/01/2012
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