Mark Richard Brouillette

NPI 1063622835 - Dentist - 1223G0001X

NPI Details
NPI 1063622835
Gender Male
Enumeration Date 05/23/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
622 N BURLINGTON AVE
YORK NE, 68467-3030, US
Phone (402) 362-3222
Fax
Business Location
622 N BURLINGTON AVE
YORK NE, 68467-3030, US
Phone (402) 362-3222
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Nebraska
License Number 5539
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According to our database, Dr. Mark Richard Brouillette NPI is 1063622835, taxonomy code is 1223G0001X and license number is 5539, license state is located at Nebraska. Mark Richard Brouillette physically located at 622 N Burlington Ave, York NE, 68467-3030. NPI Number Mark Richard Brouillette has the Individual type.

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1063622835 NPI number is provided on an as is basis without warranty of any kind. 1063622835 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Richard Brouillette are for informational purposes only.