# SCOTT A. BROADBENT, D.D.S, P.S.

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

## Provider details

- **NPI number:** 1699873844
- **Authorized official:** LISA OLSON (OFFICE ADMISTRATION)
- **Authorized official phone:** (360) 697-3331

## Contact information

- **Practice address:** 19365 7TH AVE NE, SUITE 110, POULSBO, WA 98370-7441
- **Practice address phone:** (360) 697-3331
- **Practice address fax:** (360) 697-4610
- **Mailing address:** 19365 7TH AVE NE STE 110, POULSBO, WA 98370-7441

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00006455 | WA | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 08/14/2012