MEDICARE: DR. CURTIS ASEAL BROOKOVER 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
1	1223G0001X	General Practice Dentistry	DD1956	NM
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DD1956	NM

General Provider Information

NPI Number	:	1881609535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CURTIS ASEAL BROOKOVER DDS

Provider Business Mailing Address
First Line	:	3491 TRINITY DR
Second Line	:	SUITE A
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544-2398
Country	:	US
Telephone Number	:	505-662-4503
Fax Number	:

Provider Business Practice Location Address
First Line	:	3491 TRINITY DR
Second Line	:	SUITE A
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544-2398
Country	:	US
Telephone Number	:	505-662-4503
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	09/11/2025

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