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General NPI Number Information
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NPI Number | 1447266127
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Entity Type | Individual
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Provider Name | DR. MINDY BRODSKY
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 13889 WELLINGTON TRCE
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City | WELLINGTON
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State | FL
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Zip | 33414-2121
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Country | US
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Telephone | 561-795-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 2226 W ATLANTIC AVE SUITE W
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City | DELRAY BEACH
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State | FL
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Zip | 33445-4637
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Country | US
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Telephone | 561-330-8330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN16671
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License Number State | FL
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