Individual
DR. DAVID E BROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7776 IVANHOE AVE STE 100, LA JOLLA, CA 92037-4575
(858) 454-1468
(858) 454-1696
Mailing address
7776 IVANHOE AVE STE 100, LA JOLLA, CA 92037-4575
(858) 454-1468
(858) 454-1696
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
25483
CA
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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