| Broadway Family And Cosmetic Dentistry, P.c. | |
|
2612 W Broadway Council Bluffs IA 51501-3510 | |
| (712) 323-3615 | |
| (712) 325-6155 |
| Full Name | Broadway Family And Cosmetic Dentistry, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2612 W Broadway, Council Bluffs, Iowa |
| Authorized Official Name and Position | Gary A. Smith (OWNER) |
| Authorized Official Contact | 7123233615 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadway Family And Cosmetic Dentistry, P.c. 2612 W Broadway Council Bluffs IA 51501-3510 Ph: (712) 323-3615 | Broadway Family And Cosmetic Dentistry, P.c. 2612 W Broadway Council Bluffs IA 51501-3510 Ph: (712) 323-3615 |
| NPI Number | 1053442244 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 08/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053442244 | NPI | - | NPPES |
| 18575 | Other | IA | DELTA DENTAL OF IOWA |
| 5334 | Other | NE | BLUE CROSS |
| 18575 | Other | IA | WELLMARK |
| 039537 | Other | PA | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6699 (Iowa) | Primary |
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