Provider Demographics
NPI:1992701387
Name:ARMSTRONG, BROOKIE DENISE (DDS)
Entity type:Individual
Prefix:DR
First Name:BROOKIE
Middle Name:DENISE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:205 E UNIVERSITY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-6814
Mailing Address - Country:US
Mailing Address - Phone:512-864-1445
Mailing Address - Fax:512-864-1447
Practice Address - Street 1:2411 WILLIAMS DR
Practice Address - Street 2:STE 111
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-3271
Practice Address - Country:US
Practice Address - Phone:512-864-1445
Practice Address - Fax:512-864-1447
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX155931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111085004Medicaid