Individual
DR. BEVERLY R BROADWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS PLLC
Contact information
Practice address
1921 CONCORD LAKE ROAD, KANNAPOLIS, NC 28083
(704) 723-9252
(704) 793-4531
Mailing address
1921 CONCORD LAKE ROAD, KANNAPOLIS, NC 28083
(704) 723-9252
(704) 793-4531
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6754
NC
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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