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General NPI Number Information
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NPI Number | 1417071176
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Entity Type | Organization
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Legal Business Name | ARLINGTON ORAL SURGERY
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2785 S ARLINGTON RD
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City | AKRON
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State | OH
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Zip | 44312-4703
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Country | US
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Telephone | 330-644-8401
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Fax | 330-644-8412
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Provider Business Mailing Address
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Address Line | 2785 S ARLINGTON RD
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City | AKRON
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State | OH
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Zip | 44312-4703
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Country | US
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Telephone | 330-644-8401
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Fax | 330-644-8412
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Authorized Official
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Title or Position | ORAL SURGEON
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Name | DR. JOHN BROKLOFF
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Credential | D.D.S
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Telephone | 330-644-8401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 228221
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License Number State | OH
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