Organization
BROADWAY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTI OUDERKIRK-BOCK DDS (OWNER)
(712) 263-5615
Entity
Organization
Contact information
Practice address
1415 BROADWAY, DENISON, IA 51442-2052
(712) 263-5615
(712) 263-8124
Mailing address
1415 BROADWAY, DENISON, IA 51442-2052
(712) 263-5615
(712) 263-8124
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07912
IA
Other
Enumeration date
03/08/2007
Last updated
04/04/2025
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