Individual
DR. ADELE BRONKHORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCHD, MDENT (ORTHO)
Contact information
Practice address
300 LONGWOOD AVE # HU-226, BOSTON, MA 02115-5724
(857) 218-5540
(617) 730-0478
Mailing address
300 LONGWOOD AVE # HU-226, BOSTON, MA 02115-5724
(857) 218-5540
(617) 730-0478
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DL11164
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1200445
—
MA
Enumeration date
11/08/2010
Last updated
11/08/2010
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