Mark A Broussard, DDS

NPI #1083783302 in Crowley, Louisiana

Provider Information

NPI Number: 1083783302
Entity Type: Individual
Name: Mark A Broussard, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Nov 8, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 608 NORTH AVENUE K
City: Crowley
State: Louisiana
ZIP Code: 70526
Phone: (337) 788-0677

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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