Provider Demographics
NPI:1164548723
Name:BROCHSTEIN, ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:BROCHSTEIN
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:PO BOX 79496
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30357-7496
Mailing Address - Country:US
Mailing Address - Phone:404-874-4282
Mailing Address - Fax:
Practice Address - Street 1:999 PEACHTREE ST NE
Practice Address - Street 2:STE. 705
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3915
Practice Address - Country:US
Practice Address - Phone:404-874-4282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA95291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice