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Individual

DR. FREDERICK WRIGHT BROADHEAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
80 W 4TH ST, FRONT ROYAL, VA 22630-2608
(540) 635-4567
(540) 635-6177
Mailing address
80 W 4TH ST, FRONT ROYAL, VA 22630-2608
(540) 635-4567
(540) 635-6177

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401411086
VA
122300000X
Dentist
4053
SC

Other

Enumeration date
07/31/2007
Last updated
10/09/2007
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