Individual
JAMES R BRODERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
90 MILL ST, DAYTON, VA 22821
(540) 879-9845
(540) 879-3255
Mailing address
PO BOX 897, DAYTON, VA 22821
(540) 879-9845
(540) 879-3255
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4381
VA
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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