| Kenneth Brochin, D.d.s., Llc | |
|
4210 W Central Ave Ottawa Hills OH 43606-2270 | |
| (419) 535-1066 | |
| (419) 535-1379 |
| Full Name | Kenneth Brochin, D.d.s., Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4210 W Central Ave, Ottawa Hills, Ohio |
| Authorized Official Name and Position | Deborah S Detterman (OFFICE MANAGER) |
| Authorized Official Contact | 4195351066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Brochin, D.d.s., Llc 4210 W Central Ave Ottawa Hills OH 43606-2270 Ph: (419) 535-1066 | Kenneth Brochin, D.d.s., Llc 4210 W Central Ave Ottawa Hills OH 43606-2270 Ph: (419) 535-1066 |
| NPI Number | 1447626049 |
|---|---|
| Provider Enumeration Date | 08/18/2015 |
| Last Update Date | 08/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447626049 | NPI | - | NPPES |
| 0336023 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 15261 (Ohio) | Primary |