Broadway Smiles Dental, LLC
Organization Active NPI General Practice Dentistry · Oak Grove, MO
NPI 1144801622 · NPPES record last updated Apr 16, 2021
Key facts
- NPI
- 1144801622
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- BROADWAY SMILES DENTAL, LLC
- Practice address
- 2016 S Broadway # 8439
Oak Grove, MO 64075-8439 - Phone
- (816) 690-7757
- NPI assigned
- Apr 16, 2021
- Organization subpart
- No
Authorized official
- Name
- Dr. Staci Nicole Osgood, DDS
- Title
- General Dentist
- Phone
- (913) 558-3919
Practitioners 1
-
Staci Nicole Osgood, DDS
National Provider Directory
Locations
2016 S Broadway
#8439
Oak Grove, MO 64075
Phone (816) 690-7757
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
2016 S Broadway # 8439
Oak Grove, MO 64075-8439
Mailing address
6724 E 134TH St
Grandview, MO 64030-3236
Phone (913) 558-3919
Other providers in Oak Grove, MO
- Michele Renee Beel
- Isaac Lee Beitz
- Patricia Ann Bettels Rhodes
- Arielle Marie Bradley
- Bristol Care, Inc.
- Moriah Nicole Sue Brooks
- George Joseph Bures III
- Tracy Lynn Byrd
- Carondelet Physician Services Inc
- Samantha Jo Castlebury
All providers in Oak Grove, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.