Provider Demographics
NPI:1447984117
Name:BRASSEAUX, CHRISTOPHER ERIC (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ERIC
Last Name:BRASSEAUX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6568 HIGHWAY 165 N APT 1103
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-8754
Mailing Address - Country:US
Mailing Address - Phone:972-984-8354
Mailing Address - Fax:
Practice Address - Street 1:2914 BETIN AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7258
Practice Address - Country:US
Practice Address - Phone:318-323-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-10
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7360122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist