Organization
HOLY FAMILY DENTAL CLINICS
Active
Other names
Holy Family Dental Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONNIE D BOUCHARD DO (PRESIDENT)
(269) 621-0011
Entity
Organization
Contact information
Practice address
2 E MAIN ST, HARTFORD, MI 49057-1120
(269) 621-0011
(269) 308-3336
Mailing address
301 N CENTER ST, HARTFORD, MI 49057-1199
(269) 621-0011
(269) 308-3336
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164170577
—
MI
Enumeration date
03/15/2022
Last updated
06/01/2022
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