Individual provider · Type 1 NPI

Jack S. Broussard Jr., DDS

General Practice Dentistry · Pasadena, CA

NPI number 1821093832 Active

Practice location

301 S Fair Oaks Ave, Ste 204
Pasadena, CA 91105-2536

Call (626) 796-3161 Map

Fax (626) 796-6760

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001XDN26040 (CA)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1821093832

Jack S. Broussard Jr., DDS's National Provider Identifier is 1821093832, issued on Jun 16, 2005. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Pasadena, CA. The record was last updated on Oct 25, 2007.