Broadway Smiles PC
NPI #1194075341 in Sulphur Springs, Texas
Provider Information
- NPI Number
- 1194075341
- Entity Type
- Organization
- Organization Name
- Broadway Smiles PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 14, 2012
- Last Updated
- Sep 14, 2012
Practice Location
- Address
- 1707 S BROADWAY ST
- Address 2
- SUITE 10
- City
- Sulphur Springs
- State
- Texas
- ZIP Code
- 75482-4960
- Phone
- (703) 338-9736
Authorized Official
- Name
- DR. PRAVEENA SEETHARAM SHETTY, DMD
- Title
- OWNER
- Phone
- (703) 338-9736
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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