| NPI | 1104397868 |
|---|---|
| Doing Business As | BROADWAY DENTAL |
| Entity Type | Organization |
| Authorized Contact | MATTHEW D GRACE Dentist 903-316-9419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2018-12-06 |