National Provider Identifier
Mary Rachelle Broderick, RDH
Mary Rachelle Broderick, RDH is listed in the NPPES registry with a primary specialty of Dental Hygienist in Appleton, NY and a listed phone number of (716) 297-0798.
Profile Overview
- NPI
- 1134401490
- Provider Type
- Individual
- Primary Specialty
- Dental Hygienist
- Enumeration Date
- September 13, 2011
- Last Updated
- September 13, 2011
Practice Location
- 6419 Lake RD
- Appleton, NY 14008-9606
Phone: (716) 297-0798
Specialties
- Dental Hygienist (124Q00000X)
Full Record
- NPI
- 1134401490
- Entity Type
- Individual
- Last Name
- Broderick
- First Name
- Mary
- Middle Name
- Rachelle
- Name Prefix
- MS.
- Credential
- RDH
- Mailing Street Address
- 6419 Lake RD
- Mailing City
- Appleton
- Mailing State
- NY
- Mailing ZIP Code
- 14008-9606
- Mailing Country
- US
- Mailing Phone
- (716) 297-0798
- Mailing Fax
- (716) 297-0998
- Practice Street Address
- 6419 Lake RD
- Practice City
- Appleton
- Practice State
- NY
- Practice ZIP Code
- 14008-9606
- Practice Country
- US
- Practice Phone
- (716) 297-0798
- Practice Fax
- (716) 297-0998
- Enumeration Date
- September 13, 2011
- Last Updated
- September 13, 2011
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dental Hygienist (124Q00000X)
- Other Identifiers
- 016112-1 (NY, New York State License)