Broderick, John G.
Broderick, John G. is an individual health care provider with primary practice located at 167 Gano St , Providence RI 02906-3808. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Broderick, John G. can be contacted via phone (401) 274-2600.Contact Information
Primary practice address
167 Gano St
Providence RI 02906-3808
Phone: (401) 274-2600
Fax: (401) 421-7875
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | DEN02700 | Rhode Island |
Profile Details
| NPI number | 1841403953 |
|---|---|
| LBN Legal business name | Broderick, John G. |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 7th, 2007 |
| 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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