Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Broad Mountain Family Dentistry, PC

Organization General Practice Dentistry · NPI 1366416828

Broad Mountain Family Dentistry, PC provides General Practice Dentistry in Frackville, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2006.

Licensed in
PA
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

309 W Pine St
Frackville, PA 17931-1211
Phone: (570) 874-3981
Fax: (570) 874-3981
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DS-029348-L (PA)

Record details

NPI number1366416828
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Frank Blozusky — Corporate President/Dentist · (570) 874-3981
NPI enumeratedFebruary 13, 2006
Last updated in NPPESAugust 22, 2020
Mailing address309 W Pine St, Frackville, PA 17931-1211

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