Individual
GREGORY W. BOUCEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5382 ESTATE OFFICE DR, MEMPHIS, TN 38119-3635
(901) 767-4270
Mailing address
5382 ESTATE OFFICE DR, MEMPHIS, TN 38119-3635
(901) 767-4270
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS4523
TN
Other
Enumeration date
11/10/2006
Last updated
07/08/2007
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