Provider Demographics
NPI:1639065642
Name:BROSI, CAYLA ANN (DMD)
Entity type:Individual
Prefix:DR
First Name:CAYLA
Middle Name:ANN
Last Name:BROSI
Suffix:
Gender:F
Credentials:DMD
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 2407
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:CA
Mailing Address - Zip Code:93644-2407
Mailing Address - Country:US
Mailing Address - Phone:559-760-6931
Mailing Address - Fax:
Practice Address - Street 1:1420 SHAW AVE STE 101
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-4072
Practice Address - Country:US
Practice Address - Phone:559-299-9008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111665122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist