Brockett, Robert L
Brockett, Robert L is an sole proprietor health care provider with primary practice located at 6129 W Corporate Oaks Dr , Crystal River FL 34429-8732. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Brockett, Robert L can be contacted via phone (352) 795-4994.Contact Information
Primary practice address
6129 W Corporate Oaks Dr
Crystal River FL 34429-8732
Phone: (352) 795-4994
Fax: (352) 795-4609
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DN 8810 | Florida |
Profile Details
| NPI number | 1730287616 |
|---|---|
| LBN Legal business name | Brockett, Robert L |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 21st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730287616 | NPPES |
| Florida | MEDICAID | 073131500 |
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