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General NPI Number Information
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NPI Number | 1598724338
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Entity Type | Individual
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Provider Name | JOHN A BREWSTER DDS
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Gender | Male
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 310 W LOSEY ST
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City | SCOTT AIR FORCE BASE
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State | IL
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Zip | 62225-5250
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Country | US
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Telephone | 618-256-2833
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Fax |
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Provider Business Mailing Address
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Address Line | 310 W LOSEY ST
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City | SCOTT AIR FORCE BASE
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State | IL
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Zip | 62225-5250
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12012424A
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License Number State | IN
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