Individual
DR. BROCK CAMERON BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8401 E 22ND ST, TUCSON, AZ 85710-6500
(520) 885-5746
Mailing address
8401 E 22ND ST, TUCSON, AZ 85710-6500
(801) 471-5615
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D010791
AZ
Other
Enumeration date
06/04/2020
Last updated
09/03/2020
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