Broadway Family Dental Center

NPI #1922378900 in Coal City, Illinois

Provider Information

NPI Number: 1922378900
Entity Type: Organization
Organization Name: Broadway Family Dental Center
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 6, 2012
Last Updated: Jan 6, 2012

Practice Location

Address: 595 N BROADWAY ST
City: Coal City
State: Illinois
ZIP Code: 60416-1046
Phone: (815) 634-8009

Authorized Official

Name: DR. PETER J PULLARA JR., D.D.S.
Title: DENTIST/OWNER
Phone: (815) 634-8009

Specialties & Taxonomy Codes

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

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Individual Providers

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Robin Trevison, D.M.D	Dentist - General Practice	Coal City	AI Deep Dive
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Coal City Dental Center	Dentist - General Practice	Coal City	AI Deep Dive
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