Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Mark A Bouchillon, DDS

Individual provider Dentist · NPI 1023109972

Mr. Mark A Bouchillon, DDS is a Dentist in Warren, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

13403 13 Mile Rd
Warren, MI 48088
Phone: (586) 979-2800
Fax: (586) 979-2720
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 2901013126 (MI)

Record details

NPI number1023109972
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedSeptember 27, 2006
Last updated in NPPESJuly 8, 2007
Mailing address13403 13 Mile Rd, Warren, MI 48088

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