Ellis David Braud Jr., D.D.S. Valid NPI
Individual provider · General Practice Dentistry · Thibodaux, LA
- NPI
- 1356561575
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 2521 (LA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2007-04-27
- Last updated
- 2007-07-08
Practice location
810 Bayou Lane
Thibodaux, LA 70301-4906
(985) 446-2888