| Broadway Smiles Pc | |
|
601 E Broadway St Cushing OK 74023-3432 | |
| (918) 285-5500 | |
| (918) 285-5502 |
| Full Name | Broadway Smiles Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 601 E Broadway St, Cushing, Oklahoma |
| Authorized Official Name and Position | Christopher Ryan Bugg (OWNER) |
| Authorized Official Contact | 9182855500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadway Smiles Pc 601 E Broadway St Cushing OK 74023-3432 Ph: (918) 285-5500 | Broadway Smiles Pc 601 E Broadway St Cushing OK 74023-3432 Ph: (918) 285-5500 |
| NPI Number | 1811161839 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 04/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811161839 | NPI | - | NPPES |
| 100845810A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5628 (Oklahoma) | Primary |
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