DR. Liberty Ann Boucher, DDS

NPI #1114183126 in Glendale, Wisconsin

Provider Information

NPI Number: 1114183126
Entity Type: Individual
Name: DR. Liberty Ann Boucher, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Jul 30, 2008
Last Updated: Jul 30, 2008

Practice Location

Address: 7040 N PORT WASHINGTON RD
City: Glendale
State: Wisconsin
ZIP Code: 53217-3838
Phone: (414) 351-6010

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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