| NPI | 1427587195 |
|---|---|
| Doing Business As | BROADWAY DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | ANGELA L LOFT Admin 651-303-3203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN 11394) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2017-06-07 |