MEDICARE: BRIGHT DENTAL AH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1730830290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT DENTAL AH LLC

Provider Business Mailing Address
First Line	:	208 N DUNTON AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-5958
Country	:	US
Telephone Number	:	888-866-3470
Fax Number	:

Provider Business Practice Location Address
First Line	:	208 N DUNTON AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-5958
Country	:	US
Telephone Number	:	888-866-3470
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SYED REHMAN
Credential	:	DMD
Telephone Number	:	888-866-3470

Provider Enumeration Date	:	01/15/2022
Last Update Date	:	09/30/2022

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