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Dr. Jack S Broussard JR., DDS
General Practice Dentistry in Pasadena, California
NPI 1821093832

Jack S Broussard JR. is a General Practice Dentistry based in Pasadena, CA and is specialized in General Practice. Jack S Broussard JR. practices in Pasadena, CA and has the professional credentials of DDS. The NPI Number for Jack S Broussard JR. is 1821093832 and holds a License No. DN26040 (California).

The current practice location address for Jack S Broussard JR. is 301 S Fair Oaks Ave, Pasadena, CA and can be reached out via phone at 626-796-3161 and via fax at 626-796-6760.

Location: 301 S Fair Oaks Ave, Pasadena, CA, 91105-2536
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821093832
Provider Name
Jack S Broussard JR.
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
301 S Fair Oaks Ave, Pasadena, CA, 91105-2536
Phone Number
626-796-3161
Fax Number
626-796-6760
Provider Enumeration Date
06/16/2005
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
301 S Fair Oaks Ave
City
Pasadena
State
California
Zip
91105-2536
Phone Number
626-796-3161
Fax Number
626-796-6760
person
Provider Business Mailing Address Details
Address
301 S Fair Oaks Ave
City
Pasadena
State
California
Zip
91105-2536
Phone Number
626-796-3161
Fax Number
626-796-6760
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
DN26040 (California)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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