NPI 1114017530 · live from the CMS NPI Registry
Drs Broderick Vaught & Dusek PC
Dentist, Orthodontics and Dentofacial Orthopedics in Savannah, GA. National Provider Identifier 1114017530, active.
NPI record
| NPI | 1114017530 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 500 Eisenhower Drive, Savannah, GA 31406 |
| Practice phone | 912-355-7022 |
| Enumerated | October 14, 2006 |
| Last updated | August 22, 2020 |
| Authorized official | Thomas Broderick, Owner Partner |
| Other names | Thomas R Broderick Robert A Vaught Mark W Dusek |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | DN010006 (GA) |
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | DN011121 (GA) |
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | DN012058 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.