Broadway Dental, P.c.

NPI #1043425697 in Portland, Oregon

Provider Information

NPI Number: 1043425697
Entity Type: Organization
Organization Name: Broadway Dental, P.c.
Primary Specialty: Clinic/Center - Dental
Enumeration Date: May 14, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1301 NE BROADWAY ST
City: Portland
State: Oregon
ZIP Code: 97232-1235
Phone: (503) 249-1100

Authorized Official

Name: EDWARD EARL GOODMAN-CHERRIER, DDS
Title: DENTIST
Phone: (503) 249-1100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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