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NPI Code Detail

MEDICARE: DR. NICHOLE EILEEN BROPHY DDS

MEDICARE: DR. NICHOLE EILEEN BROPHY DDS
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
11223G0001XGeneral Practice DentistryD009561AZ

General Provider Information

NPI Number : 1245788058
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLE EILEEN BROPHY DDS
Provider Business Mailing Address
First Line : 14858 N FRANK LLOYD WRIGHT BLVD
Second Line : SUITE 165A
City : SCOTTSDALE
State : AZ
Zip : 85260-2216
Country : US
Telephone Number : 480-860-4455
Fax Number :
Provider Business Practice Location Address
First Line : 14858 N FRANK LLOYD WRIGHT BLVD
Second Line : SUITE 165A
City : SCOTTSDALE
State : AZ
Zip : 85260-2216
Country : US
Telephone Number : 480-860-4455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2016
Last Update Date : 09/21/2016

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