DR. JACK BROUSSARD JR., D.D.S.

Dentist - General Practice

Active Individual
NPI: 1821093832

Practice Address

301 S FAIR OAKS AVE
STE 204
Pasadena, CA 91105

Phone: (626) 796-3161

Specialties

Specialty Code Primary License
Dentist - General Practice 1223G0001X Yes DN26040 (CA)

Frequently Asked Questions

NPI 1821093832 is the National Provider Identifier for DR. JACK BROUSSARD JR., D.D.S., a Dentist - General Practice provider located in Pasadena, CA. This NPI was enumerated on June 16, 2005.
DR. JACK BROUSSARD JR., D.D.S. practices at 301 S FAIR OAKS AVE, STE 204, Pasadena, CA 91105.

Quick Facts

NPI
1821093832
Type
Individual
Enumerated
Jun 16, 2005
Last Updated
Oct 25, 2007

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