Broadway Family Dentistry Pllc

NPI 1003253816 - Dentist - 122300000X

NPI Details
NPI 1003253816
Enumeration Date 06/03/2013
Last Updated 07/15/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name KAVITHA KAVITHA
Position MANAGING MEMBER
Phone (972) 864-8119
Fax (972) 926-0630
Practice Location
3200 BROADWAY BLVD
#340
GARLAND TX, 75043-1573, US
Phone (972) 864-8119
Fax (972) 926-0630
Business Location
3200 BROADWAY BLVD
#340
GARLAND TX, 75043-1573, US
Phone (972) 864-8119
Fax (972) 926-0630
Toxanomy
Taxonomy Code 122300000X
License State Texas
License Number 24059
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According to our database, Broadway Family Dentistry Pllc NPI is 1003253816, taxonomy code is 122300000X and license number is 24059, license state is located at Texas. Broadway Family Dentistry Pllc physically located at 3200 Broadway Blvd, Garland TX, 75043-1573. NPI Number 1033115704 has the healthcare provider type.

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1003253816 NPI number is provided on an as is basis without warranty of any kind. 1003253816 is maintained by the National Plan & Provider Enumeration System. The contents of Broadway Family Dentistry Pllc are for informational purposes only.