Reggie Harris Broom is a Gulfport, Mississippi based Pediatric Dentist who is specialized in Pediatric Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Reggie Harris Broom is 200583 for Pediatric Dentistry in Mississippi. His current practice location is 1635 E Pass Road, Gulfport. Patients can reach him at 228-896-5197.
Reggie Harris Broom 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 Profile:
Reggie Harris Broom speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Reggie Harris Broom
Specialization:
Pediatric Dentist
Gender:
Male
Credentials:
DMD
Accepts Medicare Assignment:
No
Practice Address:
1635 E Pass Road, Gulfport, Mississippi, 39507
Phone:
228-896-5197
Fax:
228-896-5192
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 are as mentioned below.
NPI Number:
1063588788
NPI Enumeration Date:
27 Nov, 2006
NPI Last Update On:
08 Jul, 2007
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Reggie Harris Broom are as mentioned below.
License Number
Specialization
State
Status
200583
Pediatric Dentistry
Mississippi
Primary
11986
Pediatric Dentistry
Mississippi
Secondary
Other Medical Identifiers:
Other legacy medical identifiers associated with Reggie Harris Broom such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
H66176
Other
Mississippi
UNITED CONCORDIA
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
1635 E Pass Road, Gulfport, Mississippi
Zip:
39507
Phone Number:
228-896-5197
Fax Number:
228-896-5192
Patients can reach Reggie Harris Broom at 1635 E Pass Road, 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 11 March, 2024.