| Broadway Dental Center | |
|
15 Broadway Suite 202 Passaic NJ 07055-5007 | |
| (973) 777-1202 | |
| Not Available |
| Full Name | Broadway Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15 Broadway, Passaic, New Jersey |
| Authorized Official Name and Position | Sunitha Murthy (OWNER) |
| Authorized Official Contact | 9737771202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadway Dental Center 15 Broadway Suite 202 Passaic NJ 07055-5007 Ph: (973) 777-1202 | Broadway Dental Center 15 Broadway Suite 202 Passaic NJ 07055-5007 Ph: (973) 777-1202 |
| NPI Number | 1518246453 |
|---|---|
| Provider Enumeration Date | 08/09/2011 |
| Last Update Date | 01/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518246453 | NPI | - | NPPES |
| 0409961 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DI02292800 (New Jersey) | Primary |
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Shon Dental Group Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 20 Broadway, Passaic, NJ 07055 Phone: 917-951-8657 | |
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