Broadway Dental

NPI #1396998621 in Revere, Massachusetts

Provider Information

NPI Number: 1396998621
Entity Type: Organization
Organization Name: Broadway Dental
Subpart: Yes (part of a larger organization)
Parent Organization: EUGENE BARK DMD AND ASSOCIATES
Primary Specialty: Dentist
Enumeration Date: Oct 30, 2008
Last Updated: Oct 30, 2008

Practice Location

Address: 144 BROADWAY
City: Revere
State: Massachusetts
ZIP Code: 02151-5349
Phone: (781) 284-2275

Authorized Official

Name: EUGENE BARK
Title: DENTIST
Phone: (781) 284-2275

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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