Derrick M. Broadaway, D.d.s., PC
NPI #1316156102 in Virginia Beach, Virginia
Provider Information
- NPI Number
- 1316156102
- Entity Type
- Organization
- Organization Name
- Derrick M. Broadaway, D.d.s., PC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- DERRICK M. BROADAWAY, D.D.S., PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 21, 2007
- Last Updated
- Apr 7, 2008
Practice Location
- Address
- 3809 PRINCESS ANNE RD
- Address 2
- SUITE 111
- City
- Virginia Beach
- State
- Virginia
- ZIP Code
- 23456-1900
- Phone
- (757) 471-6672
Authorized Official
- Name
- MS. JOYCE S DAVIS, CDPMA
- Title
- OFFICE MANAGER
- Phone
- (757) 471-6672
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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