Organization
DAVID E. BROCKETT D.D.S. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID EASTMAN BROCKETT DDS. (PRESIDENT)
(858) 454-1468
Entity
Organization
Contact information
Practice address
7804 IVANHOE AVE., LA JOLLA, CA 92037
(858) 454-1468
(858) 454-1696
Mailing address
7804 IVANHOE AVE., LA JOLLA, CA 92037
(858) 454-1468
(858) 454-1696
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
25483
CA
Other
Enumeration date
07/12/2010
Last updated
07/12/2010
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