Individual
MRS. WILLIAM R. BRODIE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
305 SHAFER LN, JACKSONVILLE, OR 97530-9681
(541) 899-8833
(541) 899-1769
Mailing address
305 SHAFER LN, JACKSONVILLE, OR 97530-9681
(541) 899-8833
(541) 899-1769
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4502
OR
Other
Enumeration date
07/11/2005
Last updated
07/08/2007
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