Individual provider · NPI-1

John Robert Brokenshire, DDS

Dentist, General Practice · Danville, PA

NPI number1508081332
StatusActive
Last updated in NPPESApr 29, 2020

Details

NPI
1508081332
Entity type
Individual (NPI-1)
Name
John Robert Brokenshire
Credential
DDS
Sex
Male
Sole proprietor
No
Enumeration date
Apr 16, 2007
Certification date
Apr 29, 2020
Last updated
Apr 29, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General PracticeDS024189LPAYes

Practice location

769 Bloom Rd
Danville, PA 17821-1364

Phone 570-275-1451 · Fax 570-271-1533

Mailing address

769 Bloom Rd
Danville, PA 17821-1364

Phone 570-275-1451 · Fax 570-271-1533

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