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General NPI Number Information
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NPI Number | 1538525662
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Entity Type | Organization
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Legal Business Name | BRIGHTER DENTAL
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 6221 WILSHIRE BLVD SUITE 507
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City | LOS ANGELES
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State | CA
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Zip | 90048-5201
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Country | US
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Telephone | 323-939-7899
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Fax | 323-939-6932
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Provider Business Mailing Address
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Address Line | 6221 WILSHIRE BLVD SUITE 507
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City | LOS ANGELES
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State | CA
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Zip | 90048-5201
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Country | US
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Telephone | 323-939-7899
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Fax | 323-939-6932
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Authorized Official
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Title or Position | OWNER
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Name | BABAK ELIA DARDASHTI
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Credential | DDS
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Telephone | 323-939-7899
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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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