Todd Richard Broyles in Scott Afb - Dentist
Todd Richard Broyles - NPI 1205032356
Todd Richard Broyles is a Dentist in Scott Afb, Illinois. Todd Richard Broyles practices all healthcare services and medical treatments related to Dentist. The NPI Number for Todd Richard Broyles is 1205032356. The last update date is 2007-07-08.
Todd Richard Broyles's current location address is 310 W Losey St, Scott Afb, Illinois. You can contact this provider via phone number 6182566667. The mailing address for Todd Richard Broyles is 310 W Losey St, Scott Afb, Illinois. To know further, please read the information below!
Provider Profile Detail
Provider Name | Todd Richard Broyles |
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Address | 310 W Losey St, Scott Afb, Illinois |
Phone Number | 6182566667 |
Fax Number | |
Sole Proprietor | N |
Credentials | D.D.S. |
NPI Number Detail
NPI Number | 1205032356 |
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Provider Enumeration Date | 2007-06-25 |
Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
Address | 310 W Losey St |
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City | Scott Afb |
State | Illinois (IL) |
Post Code | 622255250 |
Phone Number | 6182566667 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Dentist |
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Taxonomy | 122300000X |
Licence No | D-4068 |
Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the Todd Richard Broyles's unique identification number?
The Todd Richard Broyles has been assigned the NPI (National Provider Identifier) Number 1205032356 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical address where Todd Richard Broyles is geographically located?
The Todd Richard Broyles is physically situated at the following location: 310 W Losey St, Scott Afb, IL, 622255250.
What is Todd Richard Broyles's specialized field of practice, and what is the corresponding taxonomy classification code?
The Todd Richard Broyles's area of specialization is Dentist, and the corresponding taxonomy code that categorizes this field of practice is 122300000X.
On what date did the Todd Richard Broyles receive the assignment of its 1205032356 from the Centers for Medicare & Medicaid Services?
The Todd Richard Broyles was issued its 1205032356 by the Centers for Medicare & Medicaid Services on 2007-06-25.
When was the information regarding Todd Richard Broyles most recently updated?
The details pertaining to the Todd Richard Broyles, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.