Broadway Dentist LLC
NPI #1235381302 in Everett, Massachusetts
Provider Information
- NPI Number
- 1235381302
- Entity Type
- Organization
- Organization Name
- Broadway Dentist LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Oct 21, 2008
- Last Updated
- Oct 21, 2008
Practice Location
- Address
- 609 BROADWAY
- City
- Everett
- State
- Massachusetts
- ZIP Code
- 02149-3712
- Phone
- (617) 389-3636
Authorized Official
- Name
- PETER ITKES
- Title
- MANAGER
- Phone
- (617) 694-1614
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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