Organization · Type 2 NPI
Reggie H. Broom, D.m.d., P.a.
Pediatric Dentistry · Gulfport, MS
NPI number
1215280672
Active
Practice location
1635 E Pass Rd
Gulfport, MS 39507-3527
Fax (228) 896-5192
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Dentistry Primary | 1223P0221X | 2005-83 (MS) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
2 other providers at this address
Other pediatric dentistry providers in Gulfport
About NPI 1215280672
Reggie H. Broom, D.m.d., P.a.'s National Provider Identifier is 1215280672, issued on Oct 23, 2012. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Gulfport, MS. The record was last updated on Oct 23, 2012.