Individual
DR. RICHARD GEORGE BOUDREAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
13160 MINDANAO WAY, SUITE 120, MARINA DEL REY, CA 90292-6358
(310) 822-6161
(310) 822-6825
Mailing address
13160 MINDANAO WAY, SUITE 120, MARINA DEL REY, CA 90292-6358
(310) 822-6161
(310) 822-6825
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D21852
CA
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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