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Liberty Boucher, DDS
NPI 1114183126 · on the registry since 2008
Practice
- Address
- 7040 N Port Washington Rd
Glendale, WI 53217 - Phone
- (414) 351-6010
- Organisation at this address
- Northeast Obgyn Sc
Petrou-Haefs Eyecare, Llc
Forefront Dermatology, S.C.
Wisconsin Dental Group, S.C.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 8
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2008-07-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin