Provider Information for 1316098155
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BROADWAY FAMILY DENTAL PC
Organization Subpart: NO
NPI: 1316098155
Last Updated: 2008-03-20
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1316098155 | ||||||||||||
| Enumeration Date | 2007-01-16 | ||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||
| Status | Active | ||||||||||||
| Authorized Official Information | Name: JULIA FAIGEL DMD Title: President Phone: 6178870600 | ||||||||||||
| Mailing Address | 373 BROADWAY CHELSEA, MA 02150-2809 United States Phone: 617-887-0600 | Fax: | ||||||||||||
| Primary Practice Address | 373 BROADWAY CHELSEA, MA 02150-2809 United States Phone: 617-887-0600 | Fax: | ||||||||||||
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