Individual
CHRISTOPHER JOHN BRODOWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
931 E 86TH ST STE 207, INDIANAPOLIS, IN 46240-1852
(317) 255-0307
Mailing address
931 E 86TH ST STE 207, INDIANAPOLIS, IN 46240-1852
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12013164A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12013164A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
05/30/2019
Last updated
11/21/2022
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