Healthcare Provider Details

I. General information

NPI: 1669450292
Provider Name (Legal Business Name): TROY WILLIAM BROOKS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE WEST AVE STE 230 NAVAL BRANCH CLINIC
SARATOGA SPRINGS NY
12866
US

IV. Provider business mailing address

ROUTE 12 BLDG 449 ATTN PROFESSIONAL AFFAIRS NAVAL HEALTH CARE NEW ENGLAND
GROTON CT
06349-5600
US

V. Phone/Fax

Practice location:
  • Phone: 518-583-5300
  • Fax: 518-583-7990
Mailing address:
  • Phone: 860-694-2377
  • Fax: 860-694-2590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401410619
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: