Broadway Gentle Dentistry PC

NPI #1437238607 in Kokomo, Indiana

Provider Information

NPI Number: 1437238607
Entity Type: Organization
Organization Name: Broadway Gentle Dentistry PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Nov 6, 2006
Last Updated: Oct 6, 2014

Practice Location

Address: 2302 S DIXON RD STE 125
City: Kokomo
State: Indiana
ZIP Code: 46902-6425
Phone: (765) 453-9389

Authorized Official

Name: EDWARD T MAMARIL, DDS
Title: PRESIDENT
Phone: (765) 453-9389

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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