BROADWAY DENTAL PSC

LOUISVILLE, KY
NPI1639222466
Entity TypeOrganization
Authorized ContactRODNEY BRENT FULTZ
Sec Treasurer
502-772-7531
Organization Subpart ?No
Primary Taxonomy122300000X Dentist
Enumeration Date2007-01-18
Last Update Date2007-12-18
Business Address
BROADWAY DENTAL PSC
1813 WEST BROADWAY
LOUISVILLE, KY 40203
Phone number: 502-772-7531
Mailing Address
BROADWAY DENTAL PSC
1813 WEST BROADWAY
LOUISVILLE, KY 40203
Phone number: 502-772-7531