| Broadway Family Dentistry | |
|
1003 Broadway Fountain Hill PA 18015-4101 | |
| (610) 691-3311 | |
| (610) 317-6052 |
| Full Name | Broadway Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 1003 Broadway, Fountain Hill, Pennsylvania |
| Authorized Official Name and Position | Rami A Khoury (OWNER) |
| Authorized Official Contact | 6106913311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadway Family Dentistry 1003 Broadway Bethlehem PA 18015 Ph: (610) 691-3311 | Broadway Family Dentistry 1003 Broadway Fountain Hill PA 18015-4101 Ph: (610) 691-3311 |
| NPI Number | 1902263916 |
|---|---|
| Provider Enumeration Date | 01/21/2016 |
| Last Update Date | 01/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902263916 | NPI | - | NPPES |
| 101874749 0001 | Medicaid | PA | |
| 1215069752 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DS035891 (Pennsylvania) | Primary |
Valley Tongue Tie & Sleep Wellness Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1424 Broadway, Fountain Hill, PA 18015 Phone: 484-767-7782 |