# BROADWAY DENTAL WELLNESS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Broadway Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477245371
- **Authorized official:** DR. ANDRES SETAPUTRI DDS (OWNER)
- **Authorized official phone:** (734) 250-1473

## Contact information

- **Practice address:** 1510 N BROADWAY ST, HASTINGS, MI 49058-3024
- **Practice address phone:** (269) 945-3358
- **Mailing address:** 1510 N BROADWAY ST, HASTINGS, MI 49058-3024
- **Mailing address phone:** (269) 945-3358

## Taxonomy

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

## Other

- **Enumeration date:** 05/22/2023
- **Last updated:** 05/22/2023