Individual
DONALD ALFRED BOURBEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
837 SOUTH LAPEER ROAD, SUITE 205, OXFORD, MI 48371-5084
(248) 628-4050
(248) 628-4051
Mailing address
PO BOX 640, OXFORD, MI 48371-0640
(248) 628-4050
(248) 628-4051
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901010939
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10939
STATE BOARD OF DENTISTRY
MI
01
—
AB8411299
ST BOARD OF PHARMACY
MI
Enumeration date
02/07/2007
Last updated
07/08/2007
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