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Organization
BROADWAY FAMILY DENTAL LLC
Active
Organization
BROADWAY FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRIYA DUGGAL DMD (PERIODONTIST)
(973) 955-2022
Entity
Organization
Contact information
Practice address
15 BROADWAY, PASSAIC, NJ 07055-5007
(973) 955-2002
Mailing address
15 BROADWAY, PASSAIC, NJ 07055-5007
(973) 955-2002
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
22DI020689
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
124Q00000X
Dental Hygienist
—
—
Other
Enumeration date
10/06/2016
Last updated
10/10/2016
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