Mark Andrew Brodhagen in Green Bay - General Practice
Mark Andrew Brodhagen - NPI 1760468136
Mark Andrew Brodhagen is a General Practice in Green Bay, Wisconsin. Mark Andrew Brodhagen practices all healthcare services and medical treatments related to General Practice. The NPI Number for Mark Andrew Brodhagen is 1760468136. The last update date is 2018-09-04.
Mark Andrew Brodhagen's current location address is 1052 Bel Aire Ct, Green Bay, Wisconsin. You can contact this provider via phone number 9204992121 and fax number 9204997644. The mailing address for Mark Andrew Brodhagen is 1052 Bel Aire Ct, Green Bay, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Andrew Brodhagen |
|---|---|
| Address | 1052 Bel Aire Ct, Green Bay, Wisconsin |
| Phone Number | 9204992121 |
| Fax Number | 9204997644 |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1760468136 |
|---|---|
| Provider Enumeration Date | 2005-12-19 |
| Last Updated Date | 2018-09-04 |
Provider Mailing Address Detail
| Address | 1052 Bel Aire Ct |
|---|---|
| City | Green Bay |
| State | Wisconsin (WI) |
| Post Code | 543045015 |
| Phone Number | 9204992121 |
| Fax Number | 9204997644 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 1338G |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique identifier code issued to Mark Andrew Brodhagen by the Centers for Medicare & Medicaid Services (CMS)?
The Mark Andrew Brodhagen has been assigned the NPI (National Provider Identifier) 1760468136. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you kindly provide the complete physical address where Mark Andrew Brodhagen's facilities are geographically located?
The facilities of Mark Andrew Brodhagen are physically situated at the following location: 1052 Bel Aire Ct, Green Bay, WI, 543045015.
What is Mark Andrew Brodhagen's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mark Andrew Brodhagen's area of specialization is General Practice, and the corresponding taxonomy code that categorizes this field of practice is 1223G0001X.
On what date did the Mark Andrew Brodhagen receive its 1760468136 assignment from the Centers for Medicare & Medicaid Services?
The Mark Andrew Brodhagen was assigned its 1760468136 by the Centers for Medicare & Medicaid Services on 2005-12-19.
As of what date were the Mark Andrew Brodhagen's details last updated?
The information pertaining to the Mark Andrew Brodhagen, including its address, specialty, and other details, was most recently updated on 2018-09-04.
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