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DR. CHARLES ESTES BROADWAY D.M.D.

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1902983018

Individual Registrant:
DR. CHARLES ESTES BROADWAY D.M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
1141 S EUSTIS ST  EUSTIS, FL 32726-5558 US
Tel: 352-589-2099  Fax: 352-589-6046

Contact information for business:
1141 S EUSTIS ST  EUSTIS, FL 32726-5558 US
Tel: 352-589-2099  Fax: 352-589-6046

Registration Information:
NPI: 1902983018
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
FLDN8829

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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