NPI 1023036910 · live from the CMS NPI Registry
Michele Broder, DMD
Dentist, Periodontics in Wilmington, DE. National Provider Identifier 1023036910, active.
NPI record
| NPI | 1023036910 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Periodontics 1223P0300X |
| Practice location | 2300 Pennsylvania Ave, Suite 5c, Wilmington, DE 19806 |
| Practice phone | 302-652-1533 |
| Enumerated | July 18, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Periodontics primary | 1223P0300X | G1-0001021 (DE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.