Individual
DR. BROCK REICHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
941 TAMIAMI TRL STE F, PORT CHARLOTTE, FL 33953-3121
(402) 604-0663
Mailing address
941 TAMIAMI TRL STE F, PORT CHARLOTTE, FL 33953-3121
(402) 604-0663
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
27919
FL
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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