Organization
BROADWAY DENTAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAQSOOD A CHAUDHRY DDS (OWNER)
(703) 533-8668
Entity
Organization
Contact information
Practice address
815 W BROAD ST, SUITE A, FALLS CHURCH, VA 22046-3107
(703) 533-8668
Mailing address
815 W BROAD ST, SUITE A, FALLS CHURCH, VA 22046-3107
(703) 533-8668
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
VA
1223G0001X
General Practice Dentistry
Primary
—
VA
1223P0300X
Periodontics
—
VA
Other
Enumeration date
12/31/2012
Last updated
12/31/2012
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