Brock, John E
Brock, John E is an individual health care provider with primary practice located at 100A Prestige Park Dr , Hurricane WV 25526-8417. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Brock, John E can be contacted via phone (304) 757-0272.Contact Information
Primary practice address
100A Prestige Park Dr
Hurricane WV 25526-8417
Phone: (304) 757-0272
Fax: (304) 757-0273
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 3308 | West Virginia |
Profile Details
| NPI number | 1376555227 |
|---|---|
| LBN Legal business name | Brock, John E |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 12th, 2006 |
| Last updated | Sep 26th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376555227 | NPPES |
| West Virginia | Other | 129 | SPECIALIST, ORAL AND MAXILLOFACIAL SURGERY |
| West Virginia | Other | 3308 | SPECIALIST, ORAL AND MAXILLOFACIAL SURGERY |
| West Virginia | MEDICAID | 3810012787 | SPECIALIST, ORAL AND MAXILLOFACIAL SURGERY |
| West Virginia | Other | 10439 | SPECIALIST, ORAL AND MAXILLOFACIAL SURGERY |
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