| Broad Mountain Family Dentistry, P.c. | |
|
309 W Pine St Frackville PA 17931-1211 | |
| (570) 874-3981 | |
| (570) 874-3981 |
| Full Name | Broad Mountain Family Dentistry, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 309 W Pine St, Frackville, Pennsylvania |
| Authorized Official Name and Position | Frank Joseph Blozusky (CORPORATE PRESIDENT/DENTIST) |
| Authorized Official Contact | 5708743981 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broad Mountain Family Dentistry, P.c. 309 W Pine St Frackville PA 17931-1211 Ph: (570) 874-3981 | Broad Mountain Family Dentistry, P.c. 309 W Pine St Frackville PA 17931-1211 Ph: (570) 874-3981 |
| NPI Number | 1366416828 |
|---|---|
| Provider Enumeration Date | 02/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366416828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS-029348-L (Pennsylvania) | Primary |
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