Reggie H. Broom, D.m.d., P.a. is a Pediatric Dental Clinic in Gulfport, Mississippi. It is located at 1635 E Pass Rd, Gulfport, MS and its contact number is 228-896-5197. The authorized person for Reggie H. Broom, D.m.d., P.a. is Dr. Reggie Harris Broom
who is Pediatric Dentist/owner of the clinic and their contact number is 228-896-5197. Other organizations associated with this clinic are Coastkids Pediatric Dentistry, Pllc, Reggie H. Broom, D.m.d., P.a., The primary license number for Reggie H. Broom, D.m.d., P.a. is 2005-83 (Pediatric Dentistry) in Mississippi. Reggie H. Broom, D.m.d., P.a. Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Reggie H. Broom, D.m.d., P.a. Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Reggie H. Broom, D.m.d., P.a.
Specialization:
Pediatric Dentistry
Clinic Address:
1635 E Pass Rd, Gulfport, Mississippi, 39507-3527
Phone:
228-896-5197
Fax:
228-896-5192
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Reggie Harris Broom
Position:
Pediatric Dentist/owner
Contact Number:
228-896-5197
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Reggie H. Broom, D.m.d., P.a. clinic are as mentioned below.
NPI Number:
1215280672
NPI Enumeration Date:
23 Oct, 2012
NPI Last Update On:
23 Oct, 2012
Other Associated Organizations:
Other organizations which are associated with this clinic are as mentioned below. These organization share the same address but have similar or different specialization.
Speciality of these organizations are also mentioned below.
Name
Specialization
NPI Number
Coastkids Pediatric Dentistry, Pllc
Pediatric Dentistry
1093262974
Reggie H. Broom, D.m.d., P.a.
Pediatric Dentistry
1215280672
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Reggie H. Broom, D.m.d., P.a. are as mentioned below.
Specialization
License Number
State
Status
Pediatric Dentistry
2005-83
Mississippi
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
09015230
Medicaid
Mississippi
466176
Other
Mississippi
United Concordia
07734393
Medicaid
Mississippi
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Reggie H. Broom, D.m.d., P.a. 1635 E Pass Rd, Gulfport, Mississippi
Zip:
39507-3527
Phone Number:
228-896-5197
Fax Number:
228-896-5192
Patients can reach Reggie H. Broom, D.m.d., P.a. at 1635 E Pass Rd, Gulfport, Mississippi or can call to book an appointment on 228-896-5197. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 September, 2024.