Individual
DR. STEPHEN PAUL BRODERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7 AVENIDA VISTA GRANDE, NO.108, SANTA FE, NM 87508-9198
(505) 757-3456
(505) 757-3456
Mailing address
7 AVENIDA VISTA GRANDE, NO.108, SANTA FE, NM 87508-9198
(505) 757-3456
(505) 757-3456
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2318
NM
Other
Enumeration date
02/15/2006
Last updated
07/08/2007
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