| Broadway Dental | |
|
144 Broadway # 2 Revere MA 02151-5349 | |
| (781) 284-2275 | |
| (781) 426-7614 |
| Full Name | Broadway Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 144 Broadway # 2, Revere, Massachusetts |
| Authorized Official Name and Position | Bella Ostrovsky (MANAGER) |
| Authorized Official Contact | 7812842275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadway Dental 144 Broadway # 2 Revere MA 02151-5349 Ph: (781) 284-2275 | Broadway Dental 144 Broadway # 2 Revere MA 02151-5349 Ph: (781) 284-2275 |
| NPI Number | 1053618140 |
|---|---|
| Provider Enumeration Date | 02/25/2011 |
| Last Update Date | 10/12/2022 |
| Certification Date | 10/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053618140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN19044 (Massachusetts) | Primary |
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