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Dr. Carly Rachelle Boudreaux, DMD
Pediatric Dentist in Washington, Missouri
NPI 1326604497

Carly Rachelle Boudreaux is a Pediatric Dentist based in Youngsville, MO and is specialized in Pediatric Dentistry. Carly Rachelle Boudreaux practices in Washington, MO and has the professional credentials of DMD. The NPI Number for Carly Rachelle Boudreaux is 1326604497 and holds a License No. (Missouri).

The current practice location address for Carly Rachelle Boudreaux is 1709 Heritage Hills Dr, Washington, MO and can be reached out via phone at 636-238-3520.

Location: 1709 Heritage Hills Dr, Washington, MO, 70592-5812
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1326604497
Provider Name
Carly Rachelle Boudreaux
Credential
DMD
Provider Entity Type
Individual
Gender
Female
Address
1709 Heritage Hills Dr, Washington, MO, 70592-5812
Phone Number
636-238-3520
Fax Number
Provider Enumeration Date
05/14/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1709 Heritage Hills Dr
City
Washington
State
Missouri
Zip
63090-4621
Phone Number
636-238-3520
Fax Number
person
Provider Business Mailing Address Details
Address
1709 Heritage Hills Dr
City
Washington
State
Missouri
Zip
63090-4621
Phone Number
636-238-3520
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
2021024201 (Missouri)
Definition
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.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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