Brockman, Douglas John
Brockman, Douglas John is an individual health care provider with primary practice located at 210 S Breiel Blvd , Middletown OH 45044-5157. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Brockman, Douglas John can be contacted via phone (513) 423-9239.Contact Information
Primary practice address
210 S Breiel Blvd
Middletown OH 45044-5157
Phone: (513) 423-9239
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 18488 | Ohio |
Profile Details
| NPI number | 1174583306 |
|---|---|
| LBN Legal business name | Brockman, Douglas John |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Nov 24th, 2014 - about 10 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 | 1174583306 | NPPES |
| Ohio | MEDICAID | 0701379 | |
| Ohio | MEDICAID | 0743637 |
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