Healthcare Provider Details

I. General information

NPI: 1821787862
Provider Name (Legal Business Name): BROOK WOODS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 W MINNESOTA PARK RD
HAMMOND LA
70403-6125
US

IV. Provider business mailing address

43449 DENALI DR
HAMMOND LA
70403-0552
US

V. Phone/Fax

Practice location:
  • Phone: 985-542-3368
  • Fax:
Mailing address:
  • Phone: 405-667-4561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7860
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: