Individual
DR. MICHAEL TYLER BROADBENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1058 N HIGLEY RD, SUITE 212, MESA, AZ 85205-5399
(480) 924-8633
Mailing address
9266 E KEATS AVE, MESA, AZ 85209-2523
(480) 789-2793
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D008960
AZ
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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