DR. Jefferson C Brock

NPI #1407974215 in Skokie, Illinois

Provider Information

NPI Number
1407974215
Entity Type
Individual
Name
DR. Jefferson C Brock
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Enumeration Date
Mar 27, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
9631 GROSS POINT RD STE 1
City
Skokie
ZIP Code
60076-1264
Phone
(847) 673-6616

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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