Provider Demographics
NPI:1871811216
Name:BROKSTEIN, ARNOLD H (DDS)
Entity type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:H
Last Name:BROKSTEIN
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 1:2220 MOUNTAIN BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2958
Mailing Address - Country:US
Mailing Address - Phone:510-482-5700
Mailing Address - Fax:510-482-0407
Practice Address - Street 1:2220 MOUNTAIN BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2958
Practice Address - Country:US
Practice Address - Phone:510-482-5700
Practice Address - Fax:510-482-0407
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21784122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist