Boudreaux, Carly Rachelle

Boudreaux, Carly Rachelle is an individual health care provider with primary practice located at 1709 Heritage Hills Dr , Washington MO 63090-4621. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Boudreaux, Carly Rachelle can be contacted via phone (636) 238-3520.

Contact Information

Primary practice address
1709 Heritage Hills Dr Washington MO 63090-4621
Phone: (636) 238-3520
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / Pediatric Dentistry 1223P0221X 2021024201 Missouri

Profile Details

NPI number 1326604497
LBN Legal business name Boudreaux, Carly Rachelle
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 14th, 2019
Last updated Aug 5th, 2021 - about 4 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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