Broadway Family And Cosmetic Dentistry, Partnership

NPI 1063715969 - Dentist - 1223G0001X

NPI Details
NPI 1063715969
Enumeration Date 12/15/2010
Last Updated 12/15/2010
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name GARY A GARY
Position DENTIST
Phone (712) 323-3615
Fax (712) 325-6155
Practice Location
2612 W BROADWAY
COUNCIL BLUFFS IA, 51501-3510, US
Phone (712) 323-3615
Fax (712) 325-6155
Business Location
2612 W BROADWAY
COUNCIL BLUFFS IA, 51501-3510, US
Phone (712) 323-3615
Fax (712) 325-6155
Toxanomy
Taxonomy Code 1223G0001X
License State Iowa
License Number 6699
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According to our database, Broadway Family And Cosmetic Dentistry, Partnership NPI is 1063715969, taxonomy code is 1223G0001X and license number is 6699, license state is located at Iowa. Broadway Family And Cosmetic Dentistry, Partnership physically located at 2612 W Broadway, Council Bluffs IA, 51501-3510. NPI Number 1033115704 has the healthcare provider type.

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1063715969 NPI number is provided on an as is basis without warranty of any kind. 1063715969 is maintained by the National Plan & Provider Enumeration System. The contents of Broadway Family And Cosmetic Dentistry, Partnership are for informational purposes only.