Broadway Dental Psc in Louisville - Dentist
Broadway Dental Psc - NPI 1639222466
Broadway Dental Psc is a Dentist in Louisville, Kentucky. Broadway Dental Psc practices all healthcare services and medical treatments related to Dentist. The NPI Number for Broadway Dental Psc is 1639222466. The last update date is 2007-12-18.
Broadway Dental Psc's current location address is 1813 West Broadway, Louisville, Kentucky. You can contact this provider via phone number 5027727531. The mailing address for Broadway Dental Psc is 1813 West Broadway, Louisville, Kentucky. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Broadway Dental Psc |
|---|---|
| Address | 1813 West Broadway, Louisville, Kentucky |
| Phone Number | 5027727531 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | SEC TREASU |
|---|---|
| Authorized Official Name | Fultz Brent Rodney |
| Credentials | DMD |
| Telephone Number | 5027727531 |
NPI Number Detail
| NPI Number | 1639222466 |
|---|---|
| Provider Enumeration Date | 2007-01-18 |
| Last Updated Date | 2007-12-18 |
Provider Mailing Address Detail
| Address | 1813 West Broadway |
|---|---|
| City | Louisville |
| State | Kentucky (KY) |
| Post Code | 40203 |
| Phone Number | 5027727531 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
|
Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 61941878 | KY | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Broadway Dental Psc?
The Broadway Dental Psc has been issued the NPI (National Provider Identifier) 1639222466 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Broadway Dental Psc is geographically located?
The Broadway Dental Psc is physically situated at the following location: 1813 West Broadway, Louisville, KY, 40203.
What is Broadway Dental Psc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Broadway Dental Psc's area of specialization is Dentist, and the corresponding taxonomy code that categorizes this field of practice is 122300000X.
When was the Broadway Dental Psc's 1639222466 issued?
The Broadway Dental Psc's 1639222466 was issued on 2007-01-18.
When was the information regarding Broadway Dental Psc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Broadway Dental Psc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-12-18.
NPI Number: 1023014941
Address: 12930 Ventura Blvd, Studio City, CA
NPI Number: 1578569323
Address: 833 N Hairston Rd, Stone Mountain, GA
NPI Number: 1669479077
Address: 203 Salisbury St, Wadesboro, NC
NPI Number: 1255338570
Address: 203 Salisbury St, Wadesboro, NC
NPI Number: 1598764508
Address: 2150 Pennsylvania Ave Nw, Washington, DC
NPI Number: 1427059716
Address: 2201 Forest Ln, Garland, TX