Individual
BROC WAYNE BRIMHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
9170 JEWEL LAKE RD STE 201, ANCHORAGE, AK 99502-5390
(907) 248-7275
(907) 248-7221
Mailing address
9170 JEWEL LAKE RD STE 201, ANCHORAGE, AK 99502-5390
(907) 248-7275
(907) 248-7221
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1308
AK
1223G0001X
General Practice Dentistry
7796
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD0040
—
AK
Enumeration date
07/14/2009
Last updated
04/11/2011
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