Westside Pediatric Dentistry
NPI #1790808111 in Rio Rancho, New Mexico
Provider Information
- NPI Number
- 1790808111
- Entity Type
- Organization
- Organization Name
- Westside Pediatric Dentistry
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Apr 9, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1724 GRANDE BLVD SE
- City
- Rio Rancho
- State
- New Mexico
- ZIP Code
- 87124-1726
- Phone
- (505) 896-0245
Authorized Official
- Name
- DR. RAYMOND EDDIE BROUSSARD, DDS
- Title
- OWNER
- Phone
- (505) 896-0245
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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