Broadway Family And Cosmetic Dentistry Psc | |
556 N Broadway Lexington KY 40508-1761 | |
(859) 253-3242 | |
(859) 253-0025 |
Full Name | Broadway Family And Cosmetic Dentistry Psc |
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Speciality | Dentist - General Practice |
Location | 556 N Broadway, Lexington, Kentucky |
Authorized Official Name and Position | Aprille Rasheda Nelson (OWNER) |
Authorized Official Contact | 8592533242 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Broadway Family And Cosmetic Dentistry Psc 556 N Broadway Lexington KY 40508-1761 Ph: (859) 253-3242 | Broadway Family And Cosmetic Dentistry Psc 556 N Broadway Lexington KY 40508-1761 Ph: (859) 253-3242 |
NPI Number | 1366733644 |
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Provider Enumeration Date | 04/21/2011 |
Last Update Date | 04/21/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366733644 | NPI | - | NPPES |
7100149080 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 8731 (Kentucky) | Primary |
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