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1639222466
BROADWAY DENTAL PSC
LOUISVILLE, KY
NPI
1639222466
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Entity Type
Organization
Authorized Contact
RODNEY BRENT FULTZ
Sec Treasurer
502-772-7531
Organization Subpart ?
No
Primary Taxonomy
122300000X Dentist
Enumeration Date
2007-01-18
Last Update Date
2007-12-18
Business Address
BROADWAY DENTAL PSC
1813 WEST BROADWAY
LOUISVILLE, KY 40203
Phone number: 502-772-7531
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Mailing Address
BROADWAY DENTAL PSC
1813 WEST BROADWAY
LOUISVILLE, KY 40203
Phone number: 502-772-7531
Copy
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