Organization
BROAD MOUNTAIN FAMILY DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK JOSEPH BLOZUSKY SR. D.M.D. (CORPORATE PRESIDENT/DENTIST)
(570) 874-3981
Entity
Organization
Contact information
Practice address
309 W PINE ST, FRACKVILLE, PA 17931-1211
(570) 874-3981
(570) 874-3981
Mailing address
309 W PINE ST, FRACKVILLE, PA 17931-1211
(570) 874-3981
(570) 874-3981
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS-029348-L
PA
Other
Enumeration date
02/13/2006
Last updated
08/22/2020
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