Brock, Jefferson C
Brock, Jefferson C is an sole proprietor health care provider with primary practice located at 9631 Gross Point Rd Ste 1 , Skokie IL 60076-1264. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Brock, Jefferson C can be contacted via phone (847) 673-6616.Contact Information
Primary practice address
9631 Gross Point Rd Ste 1
Skokie IL 60076-1264
Phone: (847) 673-6616
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | A12889 | Illinois |
Profile Details
| NPI number | 1407974215 |
|---|---|
| LBN Legal business name | Brock, Jefferson C |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 27th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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