MEDICARE: BRIGHTER DENTAL CARE (MONTGOMERY & SKILLMAN)

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1033625496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTER DENTAL CARE (MONTGOMERY & SKILLMAN)

Provider Business Mailing Address
First Line	:	1030 SAINT GEORGES AVE
Second Line	:
City	:	AVENEL
State	:	NJ
Zip	:	07001-1390
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	46 VREELAND DR
Second Line	:
City	:	SKILLMAN
State	:	NJ
Zip	:	08558-2638
Country	:	US
Telephone Number	:	609-683-5300
Fax Number	:

Authorized Official
Title or Position	:	ADMIN. ASST.
Name	:	AMANDA MUCCIARIELLO
Credential	:
Telephone Number	:	732-750-0707

Provider Enumeration Date	:	12/21/2017
Last Update Date	:	12/21/2017

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Directions to “BRIGHTER DENTAL CARE (MONTGOMERY & SKILLMAN) ” Practice Location

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