Individual
DR. MICHAEL WILLIAM BROADBENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, M.S.
Contact information
Practice address
3590 HARRISON BLVD, SUITE #2, OGDEN, UT 84403-2060
(801) 392-7176
Mailing address
3590 HARRISON BLVD, SUITE #2, OGDEN, UT 84403-2060
(801) 392-7176
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6511661-9924
UT
Other
Enumeration date
05/07/2007
Last updated
04/27/2015
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