Organization
BROADWAY FAMILY AND COSMETIC DENTISTRY, PARTNERSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY A SMITH DDS (DENTIST)
(712) 323-3615
Entity
Organization
Contact information
Practice address
2612 W BROADWAY, COUNCIL BLUFFS, IA 51501-3510
(712) 323-3615
(712) 325-6155
Mailing address
2612 W BROADWAY, COUNCIL BLUFFS, IA 51501-3510
(712) 323-3615
(712) 325-6155
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6699
IA
Other
Enumeration date
12/15/2010
Last updated
12/15/2010
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