Avis Marie Broussard in Southfield - Dentist
Avis Marie Broussard - NPI 1154543833
Avis Marie Broussard is a Dentist in Southfield, Michigan. Avis Marie Broussard practices all healthcare services and medical treatments related to Dentist. The NPI Number for Avis Marie Broussard is 1154543833. The last update date is 2007-07-08.
Avis Marie Broussard's current location address is 24800 Lahser Rd, Southfield, Michigan. You can contact this provider via phone number 2483571999 and fax number 2483576014. The mailing address for Avis Marie Broussard is 24800 Lahser Rd, Southfield, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Avis Marie Broussard |
|---|---|
| Address | 24800 Lahser Rd, Southfield, Michigan |
| Phone Number | 2483571999 |
| Fax Number | 2483576014 |
| Sole Proprietor | Y |
| Credentials | D,D.S. |
NPI Number Detail
| NPI Number | 1154543833 |
|---|---|
| Provider Enumeration Date | 2007-05-03 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 24800 Lahser Rd |
|---|---|
| City | Southfield |
| State | Michigan (MI) |
| Post Code | 480343237 |
| Phone Number | 2483571999 |
| Fax Number | 2483576014 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 11532 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the Avis Marie Broussard's 1154543833?
The Avis Marie Broussard's NPI (National Provider Identifier) Number is 1154543833. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Avis Marie Broussard located?
The Avis Marie Broussard is located at 24800 Lahser Rd, Southfield, MI 480343237.
What is Avis Marie Broussard's specialized field of practice, and what is the corresponding taxonomy classification code?
The Avis Marie Broussard's area of specialization is Dentist, and the corresponding taxonomy code that categorizes this field of practice is 122300000X.
On what date did Avis Marie Broussard receive its 1154543833 assignment from the Centers for Medicare & Medicaid Services?
The Avis Marie Broussard was assigned its 1154543833 on 2007-05-03, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Avis Marie Broussard most recently updated or revised?
The details related to Avis Marie Broussard, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.
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