Organization
BROOM DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL D BROOM DDS (OWNER)
(206) 525-1414
Entity
Organization
Contact information
Practice address
4710 UNIVERSITY WAY NE, # 201, SEATTLE, WA 98105-4427
(206) 525-1414
Mailing address
4710 UNIVERSITY WAY NE, # 201, SEATTLE, WA 98105-4427
(206) 525-1414
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
WA 8255
WA
Other
Enumeration date
12/05/2016
Last updated
12/05/2016
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