Broadway Dental Center is a Dental Clinic in Montesano, Washington. It is located at 208 E Broadway Ave, Montesano, WA and its contact number is 360-249-3151. The authorized person for Broadway Dental Center is Russell M Larsen
who is Co-owner of the clinic and their contact number is 360-249-3151. The primary license number for Broadway Dental Center is DE00008166 (Dentist) in Washington. Broadway Dental Center Clinic have dental surgeons who are specialized in dentistry, diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
Complete Clinic Profile:
Broadway Dental Center Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Broadway Dental Center
Specialization:
Dentistry
Clinic Address:
208 E Broadway Ave, Montesano, Washington, 98563-3706
Phone:
360-249-3151
Fax:
360-249-5129
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Russell M Larsen
Position:
Co-owner
Contact Number:
360-249-3151
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Broadway Dental Center clinic are as mentioned below.
NPI Number:
1619073061
NPI Enumeration Date:
15 Sep, 2006
NPI Last Update On:
22 Aug, 2020
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Broadway Dental Center are as mentioned below.
Specialization
License Number
State
Status
Dentist
DE00008166
Washington
Primary
Dentist
DE00007407
Washington
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
5306808
Medicaid
Washington
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Broadway Dental Center 208 E Broadway Ave, Montesano, Washington
Zip:
98563-3706
Phone Number:
360-249-3151
Fax Number:
360-249-5129
Patients can reach Broadway Dental Center at 208 E Broadway Ave, Montesano, Washington or can call to book an appointment on 360-249-3151. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 September, 2024.