Organization · Type 2 NPI
Broadway Smile Boutique
Dental Clinic/Center · Glendale, CA
NPI number
1063208502
Active
Practice location
1100 E Broadway # 302
Glendale, CA 91205-1384
Mailing address
3331 Castleman Ln
Burbank, CA 91504-1630
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
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About NPI 1063208502
Broadway Smile Boutique's National Provider Identifier is 1063208502, issued on Apr 18, 2025. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Glendale, CA. The record was last updated on Apr 18, 2025.