Provider Demographics
NPI:1316160229
Name:BROOKS, ERIC B (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:B
Last Name:BROOKS
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 1:832 2ND STREET PIKE
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1098
Mailing Address - Country:US
Mailing Address - Phone:215-953-1717
Mailing Address - Fax:215-953-1750
Practice Address - Street 1:832 2ND STREET PIKE
Practice Address - Street 2:
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954-1098
Practice Address - Country:US
Practice Address - Phone:215-953-1717
Practice Address - Fax:215-953-1750
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018463L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics