Organization
BROADWAY DENTAL LLC
Active
Other names
dba Smiles on Broadway
Organization subpart
No
Provider details
NPI number
Authorized official
TAROLL A GRAZIANO B.S. (MANAGER)
(623) 556-7789
Entity
Organization
Contact information
Practice address
55 E. BROADWAY, TEMPE, AZ 85282
(480) 664-2244
(623) 236-9360
Mailing address
3414 W. UNION HILLS DR, UNIT 8, PHOENIX, AZ 85027
(480) 664-2244
(623) 236-9360
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D7840
AZ
1223G0001X
General Practice Dentistry
Primary
D7840
AZ
Other
Enumeration date
09/02/2011
Last updated
09/02/2011
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