Individual
DR. BRYAN BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
700 MOUNT HOPE AVE STE 610, BANGOR, ME 04401-5673
(207) 945-5952
Mailing address
592 MUDGETT RD, LEVANT, ME 04456-4146
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN5140
ME
Other
Enumeration date
05/21/2024
Last updated
05/21/2024
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