Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. RICHARD GEORGE BOUDREAU, D.D.S.
Active Sole ProprietorDR. RICHARD GEORGE BOUDREAU, D.D.S. is a Oral & Maxillofacial Surgery healthcare provider located in MARINA DEL REY, California. NPI 1003952334 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · MARINA DEL REY, CA
Registration Details
- NPI Number
- 1003952334
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 30, 2007 (19.576683970319 yrs)
- Last Updated
- Jul 8, 2007
- License
-
D21852 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
13160 MINDANAO WAYSUITE 120MARINA DEL REY, CA, 902926358Browse CA providers · Browse ZIP 90292
- Phone
- 3108226161
- Fax
- 3108226825
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.