| Broad Street Dental | |
|
1241 S Broad St Wallingford CT 06492-1737 | |
| (302) 626-5745 | |
| (203) 626-9213 |
| Full Name | Broad Street Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1241 S Broad St, Wallingford, Connecticut |
| Authorized Official Name and Position | Ayesha N Ali (DENTIST) |
| Authorized Official Contact | 3476917926 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broad Street Dental 225 Hyland Ter Orange CT 06477-1105 Ph: (347) 691-7926 | Broad Street Dental 1241 S Broad St Wallingford CT 06492-1737 Ph: (302) 626-5745 |
| NPI Number | 1346125713 |
|---|---|
| Provider Enumeration Date | 08/06/2025 |
| Last Update Date | 08/06/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346125713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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