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Organization
MATTHEW R. BROKAW, D.D.S., P.C.
Active
Organization
MATTHEW R. BROKAW, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW REED BROKAW D.D.S. (PRESIDENT/SECRETARY/OWNER)
(804) 270-6200
Entity
Organization
Contact information
Practice address
4924 DOMINION BLVD, SUITE B, GLEN ALLEN, VA 23060-6766
(804) 270-6200
(804) 965-0581
Mailing address
4924 DOMINION BLVD, SUITE B, GLEN ALLEN, VA 23060-6766
(804) 270-6200
(804) 965-0581
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401008695
VA
Other
Enumeration date
08/09/2007
Last updated
11/04/2014
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