Individual
DR. TODD STEPHEN BRASUELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
71107 HIGHWAY 21, SUITE 2, COVINGTON, LA 70433-7243
(985) 892-5942
(985) 892-8996
Mailing address
2332 COURS CARSON ST, MANDEVILLE, LA 70448-6410
(985) 674-1396
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5550
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1855502
—
LA
Enumeration date
08/12/2006
Last updated
07/08/2007
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