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Organization
BROADWAY DENTAL CENTER PC
Active
Organization
BROADWAY DENTAL CENTER PC
Active
Other names
Broadway Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUNITHA MURTHY DDS (OWNER)
(973) 777-1202
Entity
Organization
Contact information
Practice address
15 BROADWAY, SUITE 202, PASSAIC, NJ 07055-5007
(973) 777-1202
Mailing address
15 BROADWAY, SUITE 202, PASSAIC, NJ 07055-5007
(973) 777-1202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI02292800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0409961
—
NJ
Enumeration date
08/09/2011
Last updated
01/21/2015
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