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 is a 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
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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