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General NPI Number Information
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NPI Number | 1972068062
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Entity Type | Organization
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Legal Business Name | BRIGHTER SMILE DENTISTRY, P.C.
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Dates
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Enumeration Date | 02/04/2019
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 4836 MAIN ST STE 1
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City | SKOKIE
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State | IL
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Zip | 60077-2594
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Country | US
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Telephone | 847-600-3995
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Fax |
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Provider Business Mailing Address
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Address Line | 4836 MAIN ST STE 1
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City | SKOKIE
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State | IL
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Zip | 60077-2594
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Country | US
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Telephone | 847-600-3995
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | NAJMUS SAQIB OMAR
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Credential |
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Telephone | 847-600-3995
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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 |
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License Number State |
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