Organization
BROADWAY DENTAL OFFICE, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YSABEL ULERIO DDS (PRESIDENT)
(212) 942-9900
Entity
Organization
Contact information
Practice address
577 ISHAM ST, NEW YORK, NY 10034-2034
(212) 942-9900
(212) 942-2322
Mailing address
577 ISHAM ST, NEW YORK, NY 10034-2034
(212) 942-9900
(212) 942-2322
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
045323
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01510269
—
NY
Enumeration date
03/27/2008
Last updated
03/27/2008
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