| Broom Dental Llc | |
|
4710 University Way Ne # 201 Seattle WA 98105-4427 | |
| (206) 525-1414 | |
| Not Available |
| Full Name | Broom Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4710 University Way Ne, Seattle, Washington |
| Authorized Official Name and Position | Randall D Broom (OWNER) |
| Authorized Official Contact | 2065251414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broom Dental Llc 4710 University Way Ne # 201 Seattle WA 98105-4427 Ph: (206) 525-1414 | Broom Dental Llc 4710 University Way Ne # 201 Seattle WA 98105-4427 Ph: (206) 525-1414 |
| NPI Number | 1861936262 |
|---|---|
| Provider Enumeration Date | 12/05/2016 |
| Last Update Date | 12/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861936262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | WA 8255 (Washington) | Primary |
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