Individual
DR. BROCK B WESTOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.ED.
Contact information
Practice address
1101 TRUMAN ST, SAN FERNANDO, CA 91340-3237
(714) 571-3672
Mailing address
338 HILLVIEW DR, RIDGELAND, MS 39157-8606
(601) 214-6282
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
2516-89
MS
1223P0700X
Prosthodontics
Primary
61337
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72-1343206
T.I.N.
MS
Enumeration date
12/19/2006
Last updated
11/12/2021
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