Organization
JOEL E. BROUSSARD JR. D.D.S.,M.S. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL E BROUSSARD JR. D.D.S.,M.S. (OWNER)
(512) 346-1221
Entity
Organization
Contact information
Practice address
11149 RESEARCH BLVD STE 270, AUSTIN, TX 78759-5227
(512) 346-1221
(512) 502-9689
Mailing address
11149 RESEARCH BLVD STE 270, AUSTIN, TX 78759-5227
(512) 346-1221
(512) 502-9689
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8751
TX
Other
Enumeration date
07/19/2010
Last updated
08/11/2011
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