Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jefferson C Brock

Individual provider General Practice Dentistry · NPI 1407974215

Dr. Jefferson C Brock is a General Practice Dentistry in Skokie, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2007

Practice location Address checks out

9631 Gross Point Rd Ste 1
Skokie, IL 60076-1264
Phone: (847) 673-6616
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence A12889 (IL)

Record details

NPI number1407974215
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 27, 2007
Last updated in NPPESJuly 8, 2007
Mailing address9631 Gross Point Rd Ste 1, Skokie, IL 60076-1264

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