Individual
DR. CYNTHIA RENEE BOUCHARD-LAVENKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
12150 W SUNRISE BLVD, PLANTATION, FL 33323-2227
(954) 669-1469
(954) 669-1468
Mailing address
12150 W SUNRISE BLVD, PLANTATION, FL 33323-2227
(954) 669-1469
(954) 669-1468
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN19051
FL
390200000X
Student in an Organized Health Care Education/Training Program
889
FL
Other
Enumeration date
07/22/2010
Last updated
04/22/2025
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