Organization
KELLY BOUCHARD DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY BOUCHARD DMD (OWNER PRESIDENT)
(413) 733-3019
Entity
Organization
Contact information
Practice address
103 VAN DEENE AVENUE, WEST SPRINGFIELD, MA 01089
(413) 733-3019
(413) 788-7387
Mailing address
103 VAN DEENE AVENUE, WEST SPRINGFIELD, MA 01089
(413) 733-3019
(413) 788-7387
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20552
MA
Other
Enumeration date
08/08/2006
Last updated
08/22/2020
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