| Broad Street Braces | |
|
2010 S Juniper St Philadelphia PA 19148-5509 | |
| (201) 452-9270 | |
| Not Available |
| Full Name | Broad Street Braces |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2010 S Juniper St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Neil Uffner (ORTHODONTIST, OWNDER) |
| Authorized Official Contact | 2014529270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broad Street Braces 2010 S Juniper St Philadelphia PA 19148-5509 Ph: () - | Broad Street Braces 2010 S Juniper St Philadelphia PA 19148-5509 Ph: (201) 452-9270 |
| NPI Number | 1649629189 |
|---|---|
| Provider Enumeration Date | 06/06/2016 |
| Last Update Date | 06/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649629189 | NPI | - | NPPES |
| 1028648360001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DS039143 (Pennsylvania) | Primary |
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