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Individual
DR. SHELLI BOUCHER
Active
Individual
DR. SHELLI BOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0442000192
VA
1223G0001X
General Practice Dentistry
Primary
11538
NC
1223G0001X
General Practice Dentistry
8871
SC
Other
Enumeration date
08/08/2013
Last updated
07/09/2024
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