# BROADWAY SMILES DENTISTRY AND ORTHODONTICS, LLP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Broadway Smiles Dentistry and Orthodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245572379
- **Authorized official:** CARL C FAIRCHILD DDS (OWNER)
- **Authorized official phone:** (520) 750-1000

## Contact information

- **Practice address:** 5545 E BROADWAY BLVD STE 107, TUCSON, AZ 85711-3809
- **Practice address phone:** (520) 750-1000
- **Practice address fax:** (520) 750-1001
- **Mailing address:** 2860 MICHELLE DRIVE 2ND FLOOR, IRVINE, CA 92606
- **Mailing address phone:** (714) 368-2077
- **Mailing address fax:** (714) 368-2092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7462 | AZ | Yes |

## Other

- **Enumeration date:** 03/27/2013
- **Last updated:** 03/27/2013