Individual
JASON NEIL BROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5520 GLENWOOD RD, BROOKLYN, NY 11234-1128
(718) 763-0505
(718) 763-1776
Mailing address
5520 GLENWOOD RD, BROOKLYN, NY 11234-1128
(718) 763-0505
(718) 763-1776
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
053205
NY
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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