Boucher, Liberty Ann
Boucher, Liberty Ann is an individual health care provider with primary practice located at 7040 N Port Washington Rd , Glendale WI 53217-3838. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Boucher, Liberty Ann can be contacted via phone (414) 351-6010.Contact Information
Primary practice address
7040 N Port Washington Rd
Glendale WI 53217-3838
Phone: (414) 351-6010
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 6297-15 | Wisconsin |
Profile Details
| NPI number | 1114183126 |
|---|---|
| LBN Legal business name | Boucher, Liberty Ann |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 30th, 2008 |
| Last updated | Jul 30th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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