Provider Demographics
NPI:1275552895
Name:BRODSKY, HAROLD S (DDS)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:S
Last Name:BRODSKY
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 1:9110 TIVOLI PL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-5630
Mailing Address - Country:US
Mailing Address - Phone:561-488-1285
Mailing Address - Fax:561-488-1285
Practice Address - Street 1:7305 N MILITARY TRL
Practice Address - Street 2:WEST PALM BEACH VAMC - DENTAL SERVICE(160)
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-7417
Practice Address - Country:US
Practice Address - Phone:561-422-5425
Practice Address - Fax:561-422-8595
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00077831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice