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General NPI Number Information
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NPI Number | 1669619953
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Entity Type | Organization
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Legal Business Name | BRIGHTON DENTAL HEALTH, INC.
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 2201 E PECOS RD STE 2
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City | CHANDLER
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State | AZ
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Zip | 85225-6141
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Country | US
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Telephone | 480-726-2011
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 E PECOS RD STE 2
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City | CHANDLER
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State | AZ
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Zip | 85225-6141
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Country | US
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Telephone | 480-726-2011
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | TERRENCE YU
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Credential | DDS
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Telephone | 480-726-2011
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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 | 5570
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License Number State | AZ
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