Individual
DR. CARL J BREAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
300 BERTRAND DR, LAFAYETTE, LA 70506-5635
(337) 261-0214
(337) 235-3550
Mailing address
300 BERTRAND DR, LAFAYETTE, LA 70506-5635
(337) 261-0214
(337) 235-3550
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3761
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801012018
DEPARTMENT OF VETERANS AFFAIRS
LA
05
—
1837610
—
LA
Enumeration date
04/17/2007
Last updated
02/27/2020
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