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BROADWAY DENTAL, P.C.

Dental Care Facilities

Portland, Oregon

Provider NPI: 1043425697

Organization Information:
Organization Name:  BROADWAY DENTAL, P.C.
Authorized Official:  EDWARD EARL GOODMAN-CHERRIER  DENTIST  503-2491100

Practice Location:
1301 NE BROADWAY ST  PORTLAND, OR 97232 US
Tel: 503-249-1100  Fax: 503-249-2969

Business Mailing Address:
1301 NE BROADWAY ST  PORTLAND, OR 97232 US
Tel: 503-249-1100  Fax: 503-249-2969

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QD0000XAmbulatory Health Care Facilities
Clinic/Center
Dental
ORD 5439





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