Organization
CHARLES E BROADWAY, DMD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES ESTES BROADWAY DMD (DENTIST/OWNER)
(352) 589-2099
Entity
Organization
Contact information
Practice address
1141 S EUSTIS ST, EUSTIS, FL 32726-5558
(352) 589-2099
(352) 589-6046
Mailing address
1141 S EUSTIS ST, EUSTIS, FL 32726-5558
(352) 589-2099
(352) 589-6046
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN8829
FL
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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