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General NPI Number Information
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NPI Number | 1942417985
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Entity Type | Organization
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Legal Business Name | BROCK ARMS, D.D.S., P.C.
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 909 S CARMEL ST
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City | CADILLAC
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State | MI
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Zip | 49601-2586
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Country | US
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Telephone | 231-775-8281
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Fax |
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Provider Business Mailing Address
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Address Line | 909 S CARMEL ST
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City | CADILLAC
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State | MI
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Zip | 49601-2586
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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 | DENTIST
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Name | BROCK ARMS
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Credential | D.D.S., P.C.
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Telephone | 231-775-8281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | D16614
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License Number State | MI
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