MR. Raymond Eddie Broussard, DDS

NPI #1558478560 in Rio Rancho, New Mexico

Provider Information

NPI Number: 1558478560
Entity Type: Individual
Name: MR. Raymond Eddie Broussard, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Aug 24, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1724 GRANDE BLVD
City: Rio Rancho
State: New Mexico
ZIP Code: 87124
Phone: (505) 896-0245

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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