Individual
PATRICIA L BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
157 LITCHFIELD ST, TORRINGTON, CT 06790-6427
(860) 489-1328
Mailing address
127 LARKSPUR LN, BRISTOL, CT 06010-8937
(860) 585-0462
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
005714
CT
Other
Enumeration date
12/27/2007
Last updated
12/27/2007
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