Individual
DOUGLAS JOHN BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
210 S BREIEL BLVD, MIDDLETOWN, OH 45044-5157
(513) 423-9239
Mailing address
210 S BREIEL BLVD, MIDDLETOWN, OH 45044-5157
(513) 423-9239
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
18488
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0701379
—
OH
05
—
0743637
—
OH
Enumeration date
03/23/2006
Last updated
11/24/2014
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