Broad Park Family Dentistry Valid NPI

Organization · General Practice Dentistry · Mansfield, TX

NPI

1154440089

Type

Organization (Type 2)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

D21075 (TX)

Enumerated

2007-03-29

Last updated

2020-08-22