Individual provider · Type 1 NPI
Kyle Bruce Van Brocklin, DMD, M.S.
Oral and Maxillofacial Surgery (Dentist) · San Ramon, CA
NPI number
1659454015
Active
Practice location
525 Bollinger Canyon Way Ste 101
San Ramon, CA 94582-4935
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 37177 (CA) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Other oral and maxillofacial surgery (dentist) providers in San Ramon
About NPI 1659454015
Kyle Bruce Van Brocklin, DMD, M.S.'s National Provider Identifier is 1659454015, issued on Oct 21, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in San Ramon, CA. The record was last updated on Jul 8, 2007.