Individual
DR. TAMMY MARIE BOUDRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
133 PARKWAY CT, FOND DU LAC, WI 54935-3809
(920) 921-0158
Mailing address
PO BOX 1323, FOND DU LAC, WI 54936-1323
(920) 921-0158
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6050 - 15
WI
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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