Individual
DR. ROBERT T BROCKHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
9919 DORCHESTER RD, SUMMERVILLE, SC 29485-8530
(843) 875-6522
(843) 821-5343
Mailing address
9919 DORCHESTER RD, SUMMERVILLE, SC 29485-8530
(843) 875-6522
(843) 821-5343
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2224
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z2224-4
—
SC
Enumeration date
02/21/2007
Last updated
07/08/2007
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