Kim Lawrence Brokaw is a Dentist in Dixon, Illinois. Kim Lawrence Brokaw practices all healthcare services and medical treatments related to Dentist. The NPI Number for Kim Lawrence Brokaw is 1285787846. The last update date is 2007-07-08.
Kim Lawrence Brokaw's current location address is 123 N Hennepin Ave, Dixon, Illinois. You can contact this provider via phone number 8152846807. The mailing address for Kim Lawrence Brokaw is 123 N Hennepin Ave, Dixon, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kim Lawrence Brokaw |
|---|---|
| Address | 123 N Hennepin Ave, Dixon, Illinois |
| Phone Number | 8152846807 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | D.D.S, |
NPI Number Detail
| NPI Number | 1285787846 |
|---|---|
| Provider Enumeration Date | 2007-01-18 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 123 N Hennepin Ave |
|---|---|
| City | Dixon |
| State | Illinois (IL) |
| Post Code | 610212010 |
| Phone Number | 8152846807 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
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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 unique identification code assigned to Kim Lawrence Brokaw by the Centers for Medicare & Medicaid Services?
The Kim Lawrence Brokaw has been issued the NPI (National Provider Identifier) 1285787846. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Kim Lawrence Brokaw is physically located?
The Kim Lawrence Brokaw is physically situated at the following address: 123 N Hennepin Ave, Dixon, IL, 610212010.
What is Kim Lawrence Brokaw's area of expertise and its corresponding taxonomy classification?
The Kim Lawrence Brokaw's field of specialization is Dentist, and it falls under the taxonomy code 122300000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Kim Lawrence Brokaw receive its 1285787846 assignment from the Centers for Medicare & Medicaid Services?
The Kim Lawrence Brokaw was assigned its 1285787846 by the Centers for Medicare & Medicaid Services on 2007-01-18.
As of what date were the Kim Lawrence Brokaw's details last updated?
The information pertaining to the Kim Lawrence Brokaw, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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