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1083783302
MARK A BROUSSARD
CROWLEY, LA
NPI
1083783302
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: LA LA4905)
Enumeration Date
2006-11-08
Last Update Date
2007-07-08
Business Address
-- MARK A BROUSSARD DDS
608 NORTH AVENUE K
CROWLEY, LA 70526
Phone number: 337-788-0677
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Mailing Address
-- MARK A BROUSSARD DDS
608 NORTH AVENUE K
CROWLEY, LA 70526
Phone number: 337-788-0677
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