Individual
DR. STUART A BROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3400 WICKLOW LN, SUITE B, RICHMOND, VA 23236-1328
(804) 276-5060
(804) 276-5061
Mailing address
3400 WICKLOW LN, SUITE B, RICHMOND, VA 23236-1328
(804) 276-5060
(804) 276-5061
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401008293
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401008293
DENTAL LICENSE NUMBER
VA
Enumeration date
03/28/2007
Last updated
06/02/2011
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