Individual
DR. ERIC SCOTT BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MSD
Contact information
Practice address
7601 CASTOR AVE STE 300, PHILADELPHIA, PA 19152-4027
(215) 722-4290
(215) 722-3734
Mailing address
635 MEADOWBROOK DR APT 635, HUNTINGDON VALLEY, PA 19006-6913
(206) 498-0877
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
00007825
WA
1223P0300X
Periodontics
1001067-15
WI
1223P0300X
Periodontics
11876
TN
1223P0300X
Periodontics
Primary
DS028499L
PA
Other
Enumeration date
11/14/2006
Last updated
08/11/2023
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