Dr. Robert Keith Broome Jr., DDS
Dentist, General Practice in Norcross, GA. Individual provider (NPI-1).
NPI number1922366228
StatusActive
Last updated in NPPESOct 8, 2015
Details
- NPI
- 1922366228
- Entity type
- Individual (NPI-1)
- Name
- Dr. Robert Keith Broome Jr.
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 25, 2012
- Last updated
- Oct 8, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 9711 | GA | Yes |
Practice location
3875 Holcomb Bridge RdSuite 1
Norcross, GA 30092-5287
Phone 770-447-9808 · Fax 770-447-6002
Mailing address
10700 Medlock Bridge RoadSuite 202
Johns Creek, GA 30097
Phone 770-813-0079 · Fax 770-814-7407
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