Provider Demographics
NPI:1164400149
Name:BROUGHTON, JAMES H (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:H
Last Name:BROUGHTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 E. STATE ROAD # 46
Mailing Address - Street 2:SUITE B
Mailing Address - City:BATESVILLE,
Mailing Address - State:IN
Mailing Address - Zip Code:47006
Mailing Address - Country:US
Mailing Address - Phone:812-934-3651
Mailing Address - Fax:812-932-0203
Practice Address - Street 1:981 EAST. STATE ROAD # 46
Practice Address - Street 2:SUITE B
Practice Address - City:BATESVILLE,
Practice Address - State:IN
Practice Address - Zip Code:47006
Practice Address - Country:US
Practice Address - Phone:812-934-3651
Practice Address - Fax:812-932-0203
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN74071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice