| Broadway Smiles Pc | |
|
1707 S Broadway St Suite 10 Sulphur Springs TX 75482-4960 | |
| (703) 338-9736 | |
| Not Available |
| Full Name | Broadway Smiles Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1707 S Broadway St, Sulphur Springs, Texas |
| Authorized Official Name and Position | Praveena Seetharam Shetty (OWNER) |
| Authorized Official Contact | 7033389736 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadway Smiles Pc 1707 S Broadway St Suite 10 Sulphur Springs TX 75482-4960 Ph: (703) 338-9736 | Broadway Smiles Pc 1707 S Broadway St Suite 10 Sulphur Springs TX 75482-4960 Ph: (703) 338-9736 |
| NPI Number | 1194075341 |
|---|---|
| Provider Enumeration Date | 09/14/2012 |
| Last Update Date | 09/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194075341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 26239 (Texas) | Primary |
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