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Contact Information

BROADWAY FAMILY DENTAL CARE LLC
508 E BROADWAY
MILTON-FREEWATER, OR97862
 Phone: 541-938-3363
 Fax: 541-938-3912
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for BROADWAY FAMILY DENTAL CARE LLC · (Female)

NPI Number 1215001052
Status Active
Credentials
Entity Individual
Enumeration date 11/20/2006
Last updated 05/16/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • OR License # D4973
  • OR License # D8170
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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