Individual
DR. JERRY RAY BROCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
126 N 5TH ST, ONEILL, NE 68763-1565
(402) 336-4812
(402) 336-4645
Mailing address
PO BOX 815, ONEILL, NE 68763-0815
(402) 336-4812
(402) 336-4645
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4499
NE
Other
Enumeration date
11/01/2006
Last updated
11/05/2021
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