MARK BROUSSARD, DDS
Dentist - General Practice
Active
Individual
NPI: 1083783302
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dentist - General Practice | 1223G0001X | Yes | LA4905 (LA) |
Frequently Asked Questions
NPI 1083783302 is the National Provider Identifier for MARK BROUSSARD, DDS, a Dentist - General Practice provider located in Crowley, LA. This NPI was enumerated on November 8, 2006.
MARK BROUSSARD, DDS practices at 608 NORTH AVENUE K, Crowley, LA 70526.
Quick Facts
- NPI
- 1083783302
- Type
- Individual
- Enumerated
- Nov 8, 2006
- Last Updated
- Jul 8, 2007
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