Organization
MARCEL T. BOUGHER, DDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCEL TODD BOUGHER D.D.S. (PRESIDENT)
(619) 708-4060
Entity
Organization
Contact information
Practice address
6280 JACKSON DRIVE SUITE 1, SAN DIEGO, CA 92119
(619) 464-2852
Mailing address
6280 JACKSON DRIVE SUITE 1, SAN DIEGO, CA 92119
(619) 464-2852
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
47233
CA
Other
Enumeration date
07/30/2008
Last updated
07/30/2008
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