Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Broad Park Dental PA

Organization General Practice Dentistry · NPI 1083849707

Broad Park Dental PA provides General Practice Dentistry in Mansfield, Texas. Licensed in Texas. Registered with an NPI since 2009.

Licensed in
TX
In the registry since
2009
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1750 E Broad St
Mansfield, TX 76063-3400 Not confirmed with CMS for 17 years — call before visiting
Phone: (817) 473-6857
Fax: (817) 473-3256
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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 22486 (TX)

Record details

NPI number1083849707
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeremy Rudd — Owner · (817) 473-6857
NPI enumeratedMay 26, 2009
Last updated in NPPESMay 26, 2009
Mailing address1750 E Broad St, Mansfield, TX 76063-3400

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