Organization Name: | NEIL M BRODSKY DDS PA |
NPI Number: | 1033268206 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NEIL M BRODSKY (OWNER) |
Mailing Address: | 9303 Seminole Blvd #d Seminole |
State: | FL US |
Postal Code: | 337723100 |
Phone Number: | 7275485454 |
Fax Number: | |
NPI Enumeration Date: | 01/09/2007 |
NPI Last Update Date: | 04/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | DN0012131 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |