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Individual
DR. ANDREW JOSEPH BROUILLETTE
Active
Individual
DR. ANDREW JOSEPH BROUILLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6843
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008580874
DRIVER'S LICENSE
LA
Enumeration date
03/28/2018
Last updated
07/29/2024
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