Individual
DR. SCOTT BROOKSHIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
407 SPRUCE ST., CRAIG, AK 99921
(907) 826-2273
Mailing address
PO BOX 168, CRAIG, AK 99921-0168
(907) 826-2273
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
41359
CA
122300000X
Dentist
Primary
855
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41359
CALIF STATE LICENSE NUMBER
CA
01
—
855
ALASKA STATE LICENSE NUMBER
AK
Enumeration date
06/27/2013
Last updated
06/27/2013
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