Individual
DR. JOHNETTE BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
8737 COLESVILLE RD, #LL105, SILVER SPRING, MD 20910-3928
(301) 588-3083
(304) 588-3084
Mailing address
8737 COLESVILLE RD, #LL105, SILVER SPRING, MD 20910-3928
(301) 588-3083
(304) 588-3084
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12758
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011819200
—
MD
Enumeration date
03/21/2007
Last updated
06/30/2015
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