Doctor Name: | DR. JOHN S. BROUSSEAU |
NPI Number: | 1952374035 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DDS |
License Number: | 17691 |
Business Practice Address: | Karlsruherstr 144 Us Army Hospital Dental Clinic/bldg 3613 Heidelberg, BADEN WURTEMBOURG - 69126 |
Business Phone Number: | 06221172728 |
Business Fax Number: | |
Mailing Address: | In Der Bohn 18, WIESLOCH |
State: | BADEN WURTEMBOURG |
Postal Code: | 69168 |
Phone Number: | 06222385304 |
Fax Number: | |
NPI Enumeration Date: | 02/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0700X |
License Number: | 17691 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Prosthodontics |
Taxonomy Definition: | That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |