institution
Matthew R. Brokaw, D.d.s., P.c.
Dental Clinic/Center in Glen Allen, Virginia
NPI 1326230772

Matthew R. Brokaw, D.d.s., P.c. is a Dental Clinic/Center based in Glen Allen, VA and is specialized in Dental. Matthew R. Brokaw, D.d.s., P.c. practices in Glen Allen, VA. The NPI Number for Matthew R. Brokaw, D.d.s., P.c. is 1326230772 and holds a License No. 0401008695 (Virginia).

The current practice location address for Matthew R. Brokaw, D.d.s., P.c. is 4924 Dominion Blvd, Glen Allen, VA and can be reached out via phone at 804-270-6200 and via fax at 804-965-0581. You can also correspond with Matthew R. Brokaw, D.d.s., P.c. through the mailing address at 4924 DOMINION BLVD, GLEN ALLEN, VA - 23060-6766 (mailing address contact number: 804-270-6200).

Location: 4924 Dominion Blvd, Glen Allen, VA, 23060-6766
institution
Provider Profile Details
NPI Number
1326230772
Provider Name
Matthew R. Brokaw, D.d.s., P.c.
Credential
Provider Entity Type
Organization
Address
4924 Dominion Blvd, Glen Allen, VA, 23060-6766
Phone Number
804-270-6200
Fax Number
804-965-0581
Provider Enumeration Date
08/09/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
205329 01 VA ANTHEM BCBS
979564 01 VA UNITED CONCORDIA
institution
Provider Business Practice Location Address Details
Address
4924 Dominion Blvd
City
State
Zip
23060-6766
Phone Number
804-270-6200
Fax Number
804-965-0581
person
Provider Business Mailing Address Details
Address
4924 Dominion Blvd
City
State
Zip
23060-6766
Phone Number
804-270-6200
Fax Number
804-965-0581
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
License No.
0401008695 (Virginia)
Definition
Definition to come...
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