Individual
MS. EMILY BOUDEWYNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
21 GRAND ST, HARTFORD, CT 06106-1541
(860) 550-7500
(860) 550-7501
Mailing address
21 GRAND ST, HARTFORD, CT 06106-1541
(860) 550-7500
(860) 550-7501
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
007294
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235992
—
CT
Enumeration date
01/20/2009
Last updated
11/19/2010
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