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General NPI Number Information
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NPI Number | 1407516065
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Entity Type | Organization
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Legal Business Name | BOUCREE & ASSOCIATES
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Dates
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Enumeration Date | 12/23/2021
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 8555 16TH ST STE 404
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City | SILVER SPRING
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State | MD
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Zip | 20910-2802
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Country | US
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Telephone | 202-265-5910
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Fax | 301-585-5901
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Provider Business Mailing Address
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Address Line | 8555 16TH ST STE 404
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City | SILVER SPRING
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State | MD
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Zip | 20910-2802
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Country | US
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Telephone | 202-265-5910
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Fax | 301-585-5901
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Authorized Official
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Title or Position | DENTIST/ORAL SURGEON
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Name | DR. STANLEY A. BOUCREE SR.
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Credential | DDS,MS
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Telephone | 202-744-3099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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