Individual
PAUL M BROADWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2080 MURRAY HOLLADAY RD, SALT LAKE CITY, UT 84117-5132
(801) 278-7272
(801) 278-3108
Mailing address
2080 MURRAY HOLLADAY RD, SALT LAKE CITY, UT 84117-5132
(801) 278-7272
(801) 278-3108
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1424299922
UT
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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