| David E. Brockett D.d.s. Inc. | |
|
7804 Ivanhoe Ave. La Jolla CA 92037 | |
| (858) 454-1468 | |
| (858) 454-1696 |
| Full Name | David E. Brockett D.d.s. Inc. |
|---|---|
| Speciality | Dentist |
| Location | 7804 Ivanhoe Ave., La Jolla, California |
| Authorized Official Name and Position | David Eastman Brockett (PRESIDENT) |
| Authorized Official Contact | 8584541468 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David E. Brockett D.d.s. Inc. 7804 Ivanhoe Ave. La Jolla CA 92037 Ph: (858) 454-1468 | David E. Brockett D.d.s. Inc. 7804 Ivanhoe Ave. La Jolla CA 92037 Ph: (858) 454-1468 |
| NPI Number | 1114239738 |
|---|---|
| Provider Enumeration Date | 07/12/2010 |
| Last Update Date | 07/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114239738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 25483 (California) | Primary |
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