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General NPI Number Information
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NPI Number | 1184846677
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Entity Type | Organization
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Legal Business Name | BRIGHT SMILE ASSOCIATES
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | DEDICATED DENTALCARE SERVICES 1075 EASTON AVENUE
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City | SOMERSET
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State | NJ
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Zip | 08873
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Country | US
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Telephone | 732-846-5111
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Fax | 732-846-8485
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Provider Business Mailing Address
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Address Line | DEDICATED DENTALCARE SERVICES 1075 EASTON AVENUE
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City | SOMERSET
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State | NJ
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Zip | 08873
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Country | US
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Telephone | 732-846-5111
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Fax | 732-846-8485
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. JUVY GUTIERREZ
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Credential |
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Telephone | 732-846-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DI19210
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License Number State | NJ
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