Individual
ELLIS DAVID BRAUD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
810 BAYOU LANE, THIBODAUX, LA 70301-4906
(985) 446-2888
(985) 447-1007
Mailing address
810 BAYOU LN, THIBODAUX, LA 70301-4906
(985) 446-2888
(985) 447-1007
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2521
LA
Other
Enumeration date
04/27/2007
Last updated
07/08/2007
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