Organization
DR. TODD S. BRASUELL LLC
Active
Other names
Todd S. Brasuell DDS Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA MARGIOTTA (OFFICE MANAGER)
(985) 892-5942
Entity
Organization
Contact information
Practice address
189 GREENBRIER BLVD STE A, COVINGTON, LA 70433-7297
(985) 892-5942
(985) 892-8996
Mailing address
189 GREENBRIER BLVD STE A, COVINGTON, LA 70433-7297
(985) 892-5942
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1855502
—
LA
Enumeration date
09/28/2022
Last updated
10/21/2024
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