Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. CLINT OLE BRODAL, DMD
ActiveDR. CLINT OLE BRODAL, DMD is a Pediatric Dentistry healthcare provider located in MARYVILLE, Tennessee. NPI 1720235781 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · MARYVILLE, TN
Registration Details
- NPI Number
- 1720235781
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 21, 2008 (17.962937189975 yrs)
- Last Updated
- Jul 8, 2016
- Licenses
-
D9259 (OR)D9259 (OR)10289 (TN)
Practice Information
- Address
-
121 PARLIAMENT DRMARYVILLE, TN, 378046210Browse TN providers · Browse ZIP 37804
- Phone
- 8659778700
- Fax
- 8659775464
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Pediatric Dentistry
Other Pediatric Dentistry Providers in MARYVILLE, TN
| Name | Credential | NPI |
|---|---|---|
| GARRY DREW OSBORN | D.D.S. | 1689626467 |
| TIMOTHY TRAVIS JONES | — | 1235699117 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.