Organization
BROADWAY DENTAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LENA KHAYLOMSKY DMD (DENTIST)
(862) 237-7810
Entity
Organization
Contact information
Practice address
81 BROADWAY, NEWARK, NJ 07104-3801
(862) 237-7810
(862) 237-7807
Mailing address
81 BROADWAY, NEWARK, NJ 07104-3801
(862) 237-7810
(862) 237-7807
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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