Broad Park Dental Pa

LBN: Broad Park Dental Pa
Broad Park Dental Pa is an health care organization with primary practice located at 1750 E Broad St , Mansfield TX 76063-3400. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Broad Park Dental Pa can be contacted via phone (817) 473-6857, or through Rudd, Jeremy Israel via phone (817) 473-6857.

Contact Information

Primary practice address
1750 E Broad St Mansfield TX 76063-3400
Phone: (817) 473-6857
Fax: (817) 473-3256
Website:
Map and Directions
Authorized official contact:
Name: Rudd, Jeremy Israel Doctor of Dental Medicine (DMD)
Phone: (817) 473-6857

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 22486 Texas

Profile Details

NPI number 1083849707
LBN Legal business name Broad Park Dental Pa
DBA Doing business as
Authorized official Rudd, Jeremy Israel Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date May 26th, 2009
Last updated May 26th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers