Individual
DR. LEWIS CLAIR BROKAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
497 W MAIN ST, BATAVIA, OH 45103-1727
(513) 735-9111
(513) 735-9222
Mailing address
497 W MAIN ST, BATAVIA, OH 45103-1727
(513) 735-9111
(513) 735-9222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30012840
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2231516
—
OH
05
—
2431150
—
OH
Enumeration date
11/08/2006
Last updated
04/07/2008
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