Individual provider · Type 1 NPI

Mark A. Broussard, DDS

General Practice Dentistry · Crowley, LA

NPI number 1083783302 Active

About NPI 1083783302

Mark A. Broussard, DDS's National Provider Identifier is 1083783302, issued on Nov 8, 2006. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Crowley, LA. The record was last updated on Jul 8, 2007.