Broadway Dental Center, LLC
NPI #1396968251 in Passaic, New Jersey
Provider Information
- NPI Number
- 1396968251
- Entity Type
- Organization
- Organization Name
- Broadway Dental Center, LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 10, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 15 BROADWAY
- City
- Passaic
- State
- New Jersey
- ZIP Code
- 07055-5007
- Phone
- (973) 777-1202
Authorized Official
- Name
- GURAM YAKOBASHVILI, DDS
- Title
- OWNER
- Phone
- (973) 777-1202
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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