Individual
BROCK JONATHAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
900 S. ASH ST., YUMA, CO 80759
(970) 848-5777
Mailing address
615 S CEDAR ST, YUMA, CO 80759-2713
(970) 848-0960
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9241
CO
Other
Enumeration date
03/12/2007
Last updated
08/15/2007
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