Individual provider · Type 1 NPI
Carly Rachelle Boudreaux, DMD
Pediatric Dentistry · Washington, MO
NPI number
1326604497
Active
Practice location
1709 Heritage Hills Dr
Washington, MO 63090-4621
Mailing address
114 Metals Dr
Youngsville, LA 70592-5812
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
| Pediatric Dentistry Primary | 1223P0221X | 2021024201 (MO) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
2 other providers at this address
About NPI 1326604497
Carly Rachelle Boudreaux, DMD's National Provider Identifier is 1326604497, issued on May 14, 2019. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Washington, MO. The record was last updated on Aug 5, 2021.