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NPI Code Detail

MEDICARE: MR. BRIAN D. BROOKS D.D.S.

MEDICARE:  MR. BRIAN D. BROOKS  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist6112WA

General Provider Information

NPI Number : 1205833126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN D. BROOKS D.D.S.
Provider Business Mailing Address
First Line : C/O BRIAN BROOKS
Second Line : 15700 BEL RED RD
City : BELLEVUE
State : WA
Zip : 98008-2231
Country : US
Telephone Number : 425-883-3040
Fax Number :
Provider Business Practice Location Address
First Line : 15700 BEL RED RD
Second Line :
City : BELLEVUE
State : WA
Zip : 98008-2231
Country : US
Telephone Number : 425-883-3040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/08/2007

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Directions to “ MR. BRIAN D. BROOKS D.D.S.” Practice Location

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