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Broad Park Dental Pa Valid NPI

Organization · General Practice Dentistry · Mansfield, TX

NPI
1083849707
Type
Organization (Type 2)
Primary specialty
General Practice Dentistry (Dentist)
Specialty group
Dental Providers
Taxonomy code
1223G0001X
License number
22486 (TX)
Enumerated
2009-05-26
Last updated
2009-05-26
Practice location
1750 E Broad St
Mansfield, TX 76063-3400
(817) 473-6857

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