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Contact Information

CASSIDY S BOUDREAU, DMD
2836 LAKESHORE PKWY
BIRMINGHAM, AL35211-5500
 Phone: 205-434-2781
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Dentistry

1223P0221X
Indicates primary specialty

NPI Profile & details for CASSIDY S BOUDREAU · (Female)

NPI # 1164091369
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 06/22/2021
Last updated 07/14/2025 - About 11 months ago
Sole proprietor 1 No
Identifiers
  • AL License # D-0006916-C1
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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