Broadway Dental, LLC

NPI #1497258354 in Poteau, Oklahoma

Provider Information

NPI Number: 1497258354
Entity Type: Organization
Organization Name: Broadway Dental, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 16, 2018
Last Updated: Mar 16, 2018

Practice Location

Address: 2104 N BROADWAY ST
City: Poteau
State: Oklahoma
ZIP Code: 74953-2501
Phone: (918) 647-7080

Authorized Official

Name: DR. AYAN LAWSON, DMD
Title: DENTIST
Phone: (918) 448-6083

Specialties & Taxonomy Codes

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

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