Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JACK S BROUSSARD JR., D.D.S.

Active Sole Proprietor

DR. JACK S BROUSSARD JR., D.D.S. is a General Dentistry healthcare provider located in PASADENA, California. NPI 1821093832 is currently active in the NPPES registry. Verify at CMS.

General Dentistry · PASADENA, CA

Registration Details

NPI Number: 1821093832
Provider Type: Individual
Gender: Male
NPI Issued: Jun 16, 2005 (20.981164639819 yrs)
Last Updated: Oct 25, 2007
License: DN26040 (CA)
Sole Proprietor: Yes

Practice Information

Address: 301 S FAIR OAKS AVE

STE 204

PASADENA, CA, 911052536
Browse CA providers · Browse ZIP 91105
Phone: 6267963161
Fax: 6267966760
Primary Specialty: General Dentistry
1223G0001X

Other General Dentistry Providers in PASADENA, CA

Name	Credential	NPI
DR. RANJIVENDRA NATH	DDS	1669477931
DR. BYRON D. ALDER	D.D.S.	1780689760
DR. LAWRENCE FRANKLIN PERKINS	DDS	1700882974
DR. KATHLEEN JO LUCAS	DDS	1417953175
DR. PAUL P. SHINTO	D.D.S.	1801893920
DR. RODNEY K. JONES	DDS	1427059047

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.