# BROADWAY DENTAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Smile Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205372265
- **Authorized official:** HEATHER MCINTYRE (FINANCIAL COORDINATOR)
- **Authorized official phone:** (269) 445-5550

## Contact information

- **Practice address:** 110 S BROADWAY ST, CASSOPOLIS, MI 49031-1243
- **Practice address phone:** (269) 445-5550
- **Practice address fax:** (269) 445-0101
- **Mailing address:** PO BOX 8, CASSOPOLIS, MI 49031-0008
- **Mailing address phone:** (269) 445-5550
- **Mailing address fax:** (269) 445-0101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2915566 | MI | Yes |

## Other

- **Enumeration date:** 01/16/2017
- **Last updated:** 01/16/2017