| Broadway Dental, P.a. | |
|
5621 S Broadway Ave Tyler TX 75703-4348 | |
| (951) 642-0948 | |
| Not Available |
| Full Name | Broadway Dental, P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5621 S Broadway Ave, Tyler, Texas |
| Authorized Official Name and Position | Mohammad Arif (PRESIDENT) |
| Authorized Official Contact | 9516420948 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadway Dental, P.a. 5621 S Broadway Ave Tyler TX 75703-4348 Ph: () - | Broadway Dental, P.a. 5621 S Broadway Ave Tyler TX 75703-4348 Ph: (951) 642-0948 |
| NPI Number | 1740733104 |
|---|---|
| Provider Enumeration Date | 08/02/2016 |
| Last Update Date | 08/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740733104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 29244 (Texas) | Primary |
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