Brocker, Kenneth Robert

Brocker, Kenneth Robert is an individual health care provider with primary practice located at 3135 W 111Th St , Chicago IL 60655. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Brocker, Kenneth Robert can be contacted via phone (773) 238-4451.

Contact Information

Primary practice address
3135 W 111Th St Chicago IL 60655
Phone: (773) 238-4451
Fax: (773) 238-9561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X Illinois

Profile Details

NPI number 1184682791
LBN Legal business name Brocker, Kenneth Robert
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Jul 8th, 2007 - about 17 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.

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