Individual
DR. AVIS MARIE BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D,D.S.
Contact information
Practice address
24800 LAHSER RD, SOUTHFIELD, MI 48034-3237
(248) 357-1999
(248) 357-6014
Mailing address
24800 LAHSER RD, SOUTHFIELD, MI 48034-3237
(248) 357-1999
(248) 357-6014
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11532
MI
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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