Individual
DANIEL BRODKOWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 CHURCH ST, ST JOHNSBURY, VT 05819-2125
(802) 748-8353
Mailing address
113 CHURCH ST, ST JOHNSBURY, VT 05819-2125
(802) 748-8353
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
557
VT
Other
Enumeration date
01/13/2007
Last updated
07/08/2007
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