| Joshua G Brock Dds Pllc | |
|
2000 E 15th St Ste 200 Edmond OK 73013-6679 | |
| (405) 341-0203 | |
| Not Available |
| Full Name | Joshua G Brock Dds Pllc |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies |
| Location | 2000 E 15th St Ste 200, Edmond, Oklahoma |
| Authorized Official Name and Position | Joshua G Brock (OWNER) |
| Authorized Official Contact | 4053410203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joshua G Brock Dds Pllc 2000 E 15th St Edmond OK 73013-6697 Ph: (405) 341-0203 | Joshua G Brock Dds Pllc 2000 E 15th St Ste 200 Edmond OK 73013-6679 Ph: (405) 341-0203 |
| NPI Number | 1528777364 |
|---|---|
| Provider Enumeration Date | 11/21/2022 |
| Last Update Date | 06/14/2023 |
| Medicare PECOS PAC ID | 8022474931 |
|---|---|
| Medicare Enrollment ID | O20230519000139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528777364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Primary |
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