| Broad Street Dental Care | |
|
1202 S Broad St Scottsboro AL 35768-2512 | |
| (256) 259-5955 | |
| (256) 259-5954 |
| Full Name | Broad Street Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 1202 S Broad St, Scottsboro, Alabama |
| Authorized Official Name and Position | Kim Zuber (CRED SUP) |
| Authorized Official Contact | 2175405170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broad Street Dental Care 1202 S Broad St Scottsboro AL 35768-2512 Ph: (256) 259-5955 | Broad Street Dental Care 1202 S Broad St Scottsboro AL 35768-2512 Ph: (256) 259-5955 |
| NPI Number | 1851697643 |
|---|---|
| Provider Enumeration Date | 01/27/2011 |
| Last Update Date | 11/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851697643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4762 (Alabama) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | 4762 (Alabama) | Secondary |
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