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General NPI Number Information
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NPI Number | 1124745302
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Entity Type | Organization
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Legal Business Name | BRIGHT CHOICE DENTAL GROUP LP
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 6784 MARKET ST
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City | UPPER DARBY
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State | PA
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Zip | 19082-2431
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Country | US
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Telephone | 848-219-9197
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Fax |
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Provider Business Mailing Address
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Address Line | 229 DEL ROCCO CT
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City | RARITAN
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State | NJ
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Zip | 08869-2307
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Country | US
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Telephone | 848-219-9197
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALAMDEEP BRAR
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Credential |
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Telephone | 848-219-9197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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