Mark Richard Brouillette

Dentist · York, NE

Individual Active NPI

NPI number 1063622835

Practice location

622 N Burlington Ave
York, NE 68467-3030
Phone
(402) 362-3222

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NPI record

NPI
1063622835
Entity type
Individual (Type 1)
Enumeration date
May 23, 2007
Last updated
November 4, 2025
Certified
November 4, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X DO-8915 AZ
General Practice Dentistry 1223G0001X 5539 NE

About Mark Brouillette

Mark Richard Brouillette is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 622 N Burlington Ave, York, NE 68467-3030. The NPI number 1063622835 was assigned on May 23, 2007 and the record was last updated on November 4, 2025.

Mark Brouillette lists 2 licenses in the registry: #DO-8915 (AZ) for Dentist; #5539 (NE) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mark Richard Brouillette?

The NPI number is 1063622835.

What is the phone number of Mark Brouillette?

The phone number listed for the practice location is (402) 362-3222.

Where is Mark Brouillette located?

622 N Burlington Ave, York, NE 68467-3030.

What is the taxonomy code for Mark Brouillette?

The primary taxonomy code is 122300000X – Dentist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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